My practice is looking into performing fat pad biopsies in our office. Since this is a new procedure to us, I am not very familiar with biopsy procedures. The following is the technique he plans to use. The provider has suggested code 11104-Punch biopsy of skin. Is this correct based on the procedure he is planning, but I was wondering if a 10021-fine needle aspiration, without imagining guidance?
"The provider identifies an area of appropriate fat on the patient’s belly. The area is then cleaned with an antiseptic and covered with a sterile drape. The provider uses a small needle and 20 cc syringe containing lidocaine and numbs up an approximate 3X3 inch square. Once numb, the provider uses an 18 G, 1 ½ inch needle attached to a 50 cc syringe to collect a core specimen. The core is put in formalin. The provider goes back into the square area 5 or 6 times to get enough cores of fat. Each of these cores are added to the same vial of formalin. The specimens will then be sent to the hospital. The hospital will make a cell block, make the paraffin slides and do the Congo Red stain. If the Congo Red is positive, the specimen will be sent to Mayo for Mass Spec for immunotyping of the Amyloid."
Thank you for your help!
Liz Monetza, CPC, CPMA, CHONC
"The provider identifies an area of appropriate fat on the patient’s belly. The area is then cleaned with an antiseptic and covered with a sterile drape. The provider uses a small needle and 20 cc syringe containing lidocaine and numbs up an approximate 3X3 inch square. Once numb, the provider uses an 18 G, 1 ½ inch needle attached to a 50 cc syringe to collect a core specimen. The core is put in formalin. The provider goes back into the square area 5 or 6 times to get enough cores of fat. Each of these cores are added to the same vial of formalin. The specimens will then be sent to the hospital. The hospital will make a cell block, make the paraffin slides and do the Congo Red stain. If the Congo Red is positive, the specimen will be sent to Mayo for Mass Spec for immunotyping of the Amyloid."
Thank you for your help!
Liz Monetza, CPC, CPMA, CHONC