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tci Outpatient Facility Coding Alert - 2014 Issue 11

Reader Question: Don't Code 10021 and 10022 Together

Question: The physician performed a fine needle aspiration and then a needle biopsy of the same lesion at the same session. May I report both? Texas Subscriber Answer: The answer depends on why the physician performed both procedures (and, as always, the individual payer policy matters, too). For Medicare and other payers who follow Correct Coding Initiative (CCI) policies, you should report both services only if the fine needle aspiration (FNA) specimen isn’t adequate and therefore there is medical necessity for another type of biopsy. The CCI Policy Manual gives this rule in Chapter 3, Section 10 (www...

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