Radiology Coding Alert

Question: When we perform core biopsies on both thyroid nodes, I report two biopsy codes. But what codes should I report if I perform the biopsies on two nodules in the same lobe?

New York Subscriber

Answer: Medicare allows practices to report 60100* (Biopsy thyroid, percutaneous core needle) once per lesion or nodule. You should submit your claim, therefore, by reporting 60100 x 2 to represent the two nodules that you biopsied.

If the physician uses ultrasound guidance to pinpoint the biopsy location, you should also report 76942 (Ultrasonic guidance for needle placement [e.g., biopsy, aspiration, injection, localization device], imaging supervision and interpretation) once for each separate nodule biopsied. You should append modifier -59 (Distinct procedural service) to indicate that you performed the biopsies on separate and distinct anatomic areas.

Because 60100 is a starred procedure, the service includes only the surgical procedure and not any related pre- and postoperative services. If the patient requires a hospital visit for the biopsy, you should report a hospital care code (e.g., 99221-99233) in addition to 60100.

Although CPT does not specify whether you should append modifier -25 (Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure or other service) to the hospital code, some payers may require it. You should report all of your postoperative care on a service-by-service basis.