Radiology Coding Alert

Reader Questions:

Learn How to Handle a Paracentesis Case Without Accepted Modifiers

Published on Wed Jul 24, 2024

Question: I code for a hospital outpatient facility. A pulmonologist brought a patient into radiology to perform paracentesis on the patient’s pleural cavity using the radiology department’s ultrasound guidance. The radiologist read the image but didn’t assist with the procedure.

How do I report the procedure?

Connecticut Subscriber

Answer: You’ll report the procedure with 32555 (Thoracentesis, needle or catheter, aspiration of the pleural space; with imaging guidance), but you’re not done yet. Since the pulmonologist performed the paracentesis and the radiologist performed the imaging, you’ll need to indicate this in your claim with modifiers.

Assign 32555 appended with modifier 26 (Professional component) to report the pulmonologist’s portion of the procedure, and then report 32555 appended with modifier TC (Technical component…) to indicate the radiologist’s portion of the procedure. However, you should also be prepared for the claim to receive a denial.

Modifiers 26 and TC aren’t listed as accepted modifiers for 32555, so your payer will most likely deny the claim. You can appeal the denial with documentation that shows different providers performed the separate components of the procedure.

Additionally, you can always check with your individual payer to review how they’d prefer you report this unique situation.