Wiki FNA coding help

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coding4fun

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Our physician saw patient in the office for fine needle aspiration for thyroid nodule. I billed: 10022, 76942-26, 88172 with icd9 241.0. Billed procedure to Anthem and they processed claim with large adjustment off. I called Anthem & was advised that they could not tell me how to bill but keep reiterating the phrase "it is how you billed the procedure". This appears correct to me but have been told that it is not necessary to bill 88172. I would appreciate any input you guys have.
 
Is your physician also doing the cytopathology in the office, or do you send out the specimen? If you're sending it out, don't bill the 88172, that's the pathologist's charge.
 
she is doing the FNA and preparing the slides to send to the path to stain, etc and then she follows up with the pathologist for findings. I still do not believe that standing by the pathologist warrants billing for 88172. Any input from everyone would be greatly appreciated as to how your office handles this.
 
If your physician is doing the procedure in the office, does she own the US equipment? If so, then it looks to me like the billing should be;

10022 and 76942

The 88172 should not be billed.

Just my two cents.
 
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