Reader Question:
Ultrasound-Guided Breast Needle Localization
Published on Tue Jan 01, 2002
Question: How should I code an ultrasound-guided needle localization (i.e., wire placement) into a breast lesion prior to surgery? I use 19290 and 76096, but one of our new coders says this is incorrect.
Texas Subscriber
Answer: The combination of 19290 (preoperative placement of needle localization wire, breast) and 76096 (mammographic guidance for needle placement, breast e.g., for wire localization or for injection], each lesion, radiological supervision and interpretation) would have been correct for placement under mammographic guidance.
However, 76942 (ultrasonic guidance for needle placement [e.g., biopsy, aspiration, injection, localization device], imaging supervision and interpretation) was revised in CPT 2001 for clarification and is the correct code for all ultrasound guidance for needle placement, whether for biopsy, puncture or localization. Further, had the procedure been performed under stereotactic localization, 76095 (stereotactic localization guidance for breast biopsy or needle placement [e.g., for wire localization or for injection], each lesion, radiological supervision and interpretation) would have been the correct guidance code.
Many radiology practices use cheat sheets to help them code services correctly. These tools must be updated annually to keep up with coding revisions and modifications. As of Jan. 1, 2002, new CPT codes are in effect, and new ICD-9 codes were implemented Oct. 1, 2001. Coders should check any forms or templates their offices use to make sure they have been updated to reflect new and revised codes.
