annewhited
New
- Messages
- 5
- Best answers
- 0
Hi I am hoping someone could clarify billing for more than one FNA that was done.. There was a right upper AND lower pole nodule, and left lower pole nodule and several needle passes done. Would 10022 be billed just once (the passes is whats confusing me) Here is the op note
PROCEDURE: Ultrasound-guided fine needle aspiration of a right upper pole nodule measuring 3.7 x 1.8 x 2.5 cm, a right lower pole nodule with a maximal diameter of 1.3 cm, and a left lower pole nodule measuring 1.2 cm in greatest dimension.
DESCRIPTION:
The patient was brought to the minor surgery area after informed consent was obtained. She was placed supine on the exam room table. A time-out was completed. A preliminary ultrasound examination was performed, which confirmed the presence of the aforementioned lesions.
*
The neck was cleaned with chloraprep and the area for FNA selected. 1% Lidocaine plain was infiltrated in the skin over the selected areas under ultrasound guidance. Using the ultrasound, FNA biopsies were performed of the right upper pole nodule with 2 needles/passes (25 gauge X 2), the right lower pole nodule with 2 needles/passes (25 gauge X 2), and the left lower pole nodule with 3 needles/passes (25 gauge X 3). The material was expressed onto slides and smears were prepared by the cytotechnologist in the room. The residual was rinsed in CytoLyt for cell block preparation. *A representative portion of the smears were fixed in alcohol for PAP stain processing in the lab. The remainder of the smears were allowed to air dry and then stained with Diff-Quik stain. These were evaluated under the microscope by the pathologist and found to be adequate.
*
After confirming adequacy of the samples, the areas were once again inspected with ultrasound. No active bleeding or hematoma was seen. The skin was cleaned and a band aid placed over the needle puncture sites. The patient tolerated the procedure well and was given an ice pack to hold over her neck.
Any help would be greatly appreciated
Anne Domagata, cpc, cgic
PROCEDURE: Ultrasound-guided fine needle aspiration of a right upper pole nodule measuring 3.7 x 1.8 x 2.5 cm, a right lower pole nodule with a maximal diameter of 1.3 cm, and a left lower pole nodule measuring 1.2 cm in greatest dimension.
DESCRIPTION:
The patient was brought to the minor surgery area after informed consent was obtained. She was placed supine on the exam room table. A time-out was completed. A preliminary ultrasound examination was performed, which confirmed the presence of the aforementioned lesions.
*
The neck was cleaned with chloraprep and the area for FNA selected. 1% Lidocaine plain was infiltrated in the skin over the selected areas under ultrasound guidance. Using the ultrasound, FNA biopsies were performed of the right upper pole nodule with 2 needles/passes (25 gauge X 2), the right lower pole nodule with 2 needles/passes (25 gauge X 2), and the left lower pole nodule with 3 needles/passes (25 gauge X 3). The material was expressed onto slides and smears were prepared by the cytotechnologist in the room. The residual was rinsed in CytoLyt for cell block preparation. *A representative portion of the smears were fixed in alcohol for PAP stain processing in the lab. The remainder of the smears were allowed to air dry and then stained with Diff-Quik stain. These were evaluated under the microscope by the pathologist and found to be adequate.
*
After confirming adequacy of the samples, the areas were once again inspected with ultrasound. No active bleeding or hematoma was seen. The skin was cleaned and a band aid placed over the needle puncture sites. The patient tolerated the procedure well and was given an ice pack to hold over her neck.
Any help would be greatly appreciated
Anne Domagata, cpc, cgic