Wiki problems with new codes needle localized breast bx

[philgro]

Wondered if anyone else is running into this issue.

There are new codes that combine the needle localization with the biopsy itself. I can't seem to find a way to code a mammographically guided needle placement with the biopsy.

The new codes are only for MRI, ultrasound or stereotactic guidance. I can code just the mammographic needle placement 19281. I can code 19125, the old code for a needle localized bx. However, I get an edit when using both together.

I'm using 3M, which was just updated a couple of days ago.

TIA for any help!

 

[lpatt6027]

Mammographic placement of clip

Have you tried using a modifier 59? Just curious. I tried it with my Encoder Pro and it did pass with the 59 modifier. The codes you are using seem correcr for mammographic placement and biopsy. As you stated, there arent any codes for the biopsy with mammographic placement. Let me know, I am curious to see if this get paid or if you find out another way of coding this.

 

[philgro]

I was eventually told by my manager that the needle localization itself is now included in the the biopsy- previously we needed to code both.
At least at our facilities, the CDM seems to reflect this change- I haven't seen any edits come back about this.