Wiki new fine needle biopsy codes

[slund777@hotmail.com]

So my question is with the new fine needle biopsy with ultrasound guidance. Is the guidance only the PC part of 76942. Medicare states 76942 is a code you can split into 26 and TC. I have run a couple claims with 10005 and 76942TC (we own the equipment) thru insurance and they have paid, Medicare is denying saying both are included I am just wanting some clarification on if 10005 and the others include the 26 and TC of 76942. Thank You for any help on this

 

[CodingKing]

I'm not sure why they payer is reimbursing, the practice expense portion of the RVU when performed in place of service 11 includes the following equipment:
mayo stand
table, exam
ultrasound unit, portable


NCCI bundles them per parenthetical note on 76942,

Its also in the guidelines for the new FNA codes, imaging guidance is not separately reported:

FNA biopsy procedures are performed with or without imaging guidance. Imaging guidance codes (eg, 76942, 77002, 77012, 77021) may not be reported separately with 10004, 10005, 10006, 10007, 10008, 10009, 10010, 10011, 10012, 10021.

 

[slund777@hotmail.com]

Thank you for the clarification on this. It was a little confusing.