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tci Outpatient Facility Coding Alert - 2014 Issue 6

Reader Question: Know the "Why" to Report 10022

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? Alabama Subscriber Answer: The answer depends on why the physician performed both procedures (and, as always, the individual payer policy). 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, according to Medicare and other payers who follow Correct Coding Initiative (CCI) policies, The CCI Policy Manual gives this rule in Chapter 3, Section 10 (www.cms...

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