Radiology Coding Alert

Question: How many codes should I report for an ultrasound-guided thyroid biopsy with four fine needle aspirations? My radiologist wants me to report each code four times.

Tennessee Subscriber

Answer: You should report one unit of 76942 (Ultrasonic guidance for needle placement [e.g., biopsy, aspiration, injection, localization device], imaging supervision and interpretation) along with one unit of 10022 (Fine needle aspiration; with imaging guidance) for each lesion you address. Contrary to what many coders believe, you should not add a unit of 10022 for each aspiration sample obtained strictly report this code per lesion, anatomic site or cyst.

Similarly, you should bill the ultrasound guidance code once for each separate and distinct lesion targeted for biopsy and/or aspiration. Merely sampling different parts of the same lesion or making repeated passes into the same lesion does not justify your repeatedly using the guidance code.