MrsSBD
Guest
Can anyone please tell me if the below rule would apply to hospital charges also? I have asked several people on the hospital side but no one can give me an answer. I want to make sure it applies to both sides (prof and tech). Any assistance will be greatly appreciated.
According to the Society for Interventional Radiology (SIR), “a FNA (Fine Needle Aspiration) biopsy is commonly performed at the same setting as a core biopsy. When the results of the FNA are immediately available (i.e., a pathologist is on site, providing immediate interpretation of the specimen) and results from the needle aspiration support the need for a core biopsy, the service would be separately reportable. However, commonly there is no medical indication to support reporting more than one service. Therefore, it is recommended that you report the most intensive service, which is typically the core biopsy, coupled with the imaging modality-specific needle guidance code.”
“NCCI Manual Chapter 3, Subsection L, #10 states: Fine needle aspiration (FNA) (CPT codes 10021, 10022) should not be reported with another biopsy procedure code for the same lesion unless one specimen is inadequate for diagnosis. For example, an FNA specimen is usually examined for adequacy when the specimen is aspirated. If the specimen is adequate for diagnosis, it is not necessary to obtain an additional biopsy specimen. However, if the specimen is not adequate and another type of biopsy (e.g., needle, open) is subsequently performed at the same patient encounter, the other biopsy procedure code may be reported with an NCCI-associated modifier.”
Thanks
According to the Society for Interventional Radiology (SIR), “a FNA (Fine Needle Aspiration) biopsy is commonly performed at the same setting as a core biopsy. When the results of the FNA are immediately available (i.e., a pathologist is on site, providing immediate interpretation of the specimen) and results from the needle aspiration support the need for a core biopsy, the service would be separately reportable. However, commonly there is no medical indication to support reporting more than one service. Therefore, it is recommended that you report the most intensive service, which is typically the core biopsy, coupled with the imaging modality-specific needle guidance code.”
“NCCI Manual Chapter 3, Subsection L, #10 states: Fine needle aspiration (FNA) (CPT codes 10021, 10022) should not be reported with another biopsy procedure code for the same lesion unless one specimen is inadequate for diagnosis. For example, an FNA specimen is usually examined for adequacy when the specimen is aspirated. If the specimen is adequate for diagnosis, it is not necessary to obtain an additional biopsy specimen. However, if the specimen is not adequate and another type of biopsy (e.g., needle, open) is subsequently performed at the same patient encounter, the other biopsy procedure code may be reported with an NCCI-associated modifier.”
Thanks