Wiki Modifier 59 - breast biopsy

[LINDAACOSTA]

The patient had
19295-Image guided placement, metallic localization clip, percutaneous, during breast/aspiration
19103-percutaneous, automated vacuum assisted or rotating biopsy device, using imaging guidance
77031-Stereotactic guide for breast biopsy.
Can we add a modifier “59” and if yes to which one?

Thank You,

 

[deivanaiv]

Hi,

We should not append 59 modifier. 19103-Biopsy of breast paercutaneous, automated vaccum assisted or rotating biopsy device using imaging guidance.
Under this code it is given as, for imaging guidance ,use 76942,77032...... Hence we are using 19103,77032 and 19295 is an add code which must be used with 1002/19102/19103.


Hence, we must code as follows without modifier.
19103RT/LT,19295,77032.

Thanks,
Deivanai.
B.P.T,MIAP,CPC-H.

 

[TERRI GIBBS]

Our radiolgist will also examine the surgical specimen when Sterotactic guidence is used during the breast biopsy and I bill the code 76098 along with the other biopsy codes and we get paid. The Medicare reimbursement is only $18.78 but when performed it is billable.