tci General Surgery Coding Alert - 2010 Issue 12

Reader questions: 10021 and 19100 Could Trip Bundle Trap

Question: If the surgeon performs both a fine needle aspiration and a core needle biopsy for a breast mass, can we code both procedures? Answer: For Medicare, and potentially other payers as well, you should not report a fine needle aspiration (FNA) and core needle biopsy from the same breast mass. Medicare's Correct Coding Initiative (CCI) restricts when you can get paid for the following codes FNA codes: 10021 -- Fine needle aspiration; without imaging guidance 10022 -- ... with imaging guidance. These two FNA codes are column 2 (component) codes for the following core needle biopsy codes: 19100 --...

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