Otolaryngology Coding Alert

Question: An otolaryngologist takes a percutaneous biopsy of the salivary gland. Should I code this as a fine needle aspiration biopsy with 10021? Washington Subscriber Answer: No. Code 10021 (Fine needle aspiration; without imaging guidance) is for fine needle aspiration (FNA), not percutaneous needle biopsy. A percutaneous needle is larger and takes out tissue in the mass's core. Report a percutaneous needle biopsy with the anatomic site-specific surgery code. In the digestive system under the subheading "salivary gland and ducts," you will find 42400 (Biopsy of salivary gland; needle). In contrast, FNA codes (10021 and 10022, ... with imaging guidance) are in the integumentary section. These are for smaller needles that remove sample fluid from a cyst, lesion or deeper mass.