Primary Care Coding Alert

Question: Our FP took a biopsy using ultrasound to guide needle placement in the office (he owns the equipment). Can we report the ultrasound separately?

Maine Subscriber

Answer: Since he conducted the test in the office with his own ultrasound equipment, you should report the service separately. You-ll code these claims with the following codes:

- 10022 (Fine needle aspiration; with imaging guidance) for the biopsy

- 76942 (Ultrasonic guidance for needle placement, imaging supervision and interpretation) for the ultrasound.

However, when the FP performs the same procedure at the hospital, the coding will change. If the FP provided the ultrasonic guidance with interpretation and performed the biopsy in the hospital, you would code 10022 and 76942 with modifier 26 (Professional component) appended to show that you are billing only for the FP's work, not the ultrasound equipment used.

If someone on the hospital staff (a radiologist, etc.) provided the ultrasound and the FP only performed the biopsy, you would only report 10022 for the encounter.