Wiki US Guidance-76942

[Kimberley]

Can I bill for US guidance x 3????

ULTRASOUND-GUIDED FINE-NEEDLE ASPIRATION AND CORE BIOPSIES OF THE RIGHT
BREAST FOR THREE LESIONS
INDICATION: Enlarging nodules, right breast.
TECHNIQUE/FINDINGS: Consent was obtained from the patient.
Enlarging nodules that are deep to the right breast at 9 to 10 o'clock and in the right axilla
were again identified sonographically.
Using ultrasound guidance and sterile technique, each of these nodules was fine-needle
aspirated with an 18-gauge needle and core biopsied with a 16-gauge needle. The
structure in the axilla is believed to represent an enlarging lymph node. The other lesions
could represent slowly enlarging metastatic nodules. Considerations include metastatic
melanoma and breast carcinoma. The patient does have a history of ductal carcinoma in
situ in the contralateral left breast. The lesions however are unlikely to be breast related.
The favored diagnosis would be metastatic melanoma or perhaps another lymph node
reactive process. Pathology is pending. No complications were encountered. IMPRESSION: Successful biopsy of masses in the right breast as described. Again,
metastatic disease would be the primary consideration since these are enlarging. BI-RADS CATEGORY: 4-Suspicious abnormality.

 

[cmcgarry]

You would only bill the 76942 once, and with a -26 modifier if the biopsy was done at the hospital or surgery center, global if done in the office.

 

[Kimberley]

Just once even though bx was done at at 9, 10 and axilla????

 

[cmcgarry]

Yes - any kind of guidance is only billed once per surgical session. For example, when doing FNA of thyroid nodules, even if the physician aspirates in three different locations, the U/S guidance is only billed once. If doing transforaminal epidural injections in the spine, U/S is billed once no matter how many levels were injected.

Code 76942 does have a "medically unlikely edit" number of 1, meaning it should only be billed once per day.

Hope this helps.