Wiki Breast Bx

[NJcoder]

Can code 19102 (percutaneous, needle core) and 19103 (percutaneous, automated vacuum assisted) be coded together for same breast?

thx

 

[laston]

The ACS states:

Unbundling Allowed With Appropriate Modifier

Code 19103 (RVU: 5.32) and 19102 (RVU: 2.87) are mutually exclusive. You may typically only bill one of them. You may unbundle them only if you can justify the use of an appropriate modifier. If you are unable to justify the use of a modifier, you should bill 19103 (RVU: 5.32) alone because it has a higher RVU than 19102 (RVU: 2.87). If you try to bill them together without modifier justification, code 19103 (RVU: 5.32) is at risk. Medicare will reimburse for 19102 (RVU: 2.87) at the lower RVU instead.

It states that modifiers 50 & 51 can be used.

I hope that helps.