AHA Coding Clinic® for HCPCS - 2025 Issue 1; Ask the Editor

Percutaneous liver biopsies

A patient with multiple liver lesions presented for percutaneous biopsies of each lesion. The patient was provided with conscious sedation and placed supine on the bed. An appropriate access site was selected, and the area was prepped and draped in the usual sterile fashion. The skin and subcutaneous tissues were anesthetized with 1% lidocaine, and a small skin incision was made.Next under ultrasonic guidance a 17-gauge coaxial needle was advanced to an inferior hypoechoic lesion. A single biopsy was performed. The pathologist noted only hepatocytes. Ultrasound clearly demonstrated the needle within the lesion. A second lesion was then selected immediately adjacent to the first and an additional biopsy was obtained. Finally, a third, and then a fourth lesion were selected and biopsied via percutaneous needle. Gelfoam slurry was injected as the needles were removed. The patient tolerated the procedure well without immediate complication.Would this procedure be captured with one unit of CPT code 47000, Biopsy of liver, needle; percutaneous, or should it be reported with four units, once for each lesion biopsied? ...

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