Fine Needle Aspiration Coding Updated for 2019
CPT® coding for fine needle aspiration, or FNA, will change dramatically for 2019. Details of the changes have begun to trickle out after the AMA announced its release of the new CPT® code set on September 5.
As of Jan. 1, 2019, you may no longer report fine need aspiration separately with imaging guidance, as previously allowed. Instead, CPT® will offer a single code to report fine needle aspiration of an initial lesion, without imaging guidance, and four new codes to report fine needle aspiration of an initial lesion using specified imaging modalities, including ultrasound, fluoroscopy, computed tomography (CT), and magnetic resonance (MR).
You’ll use add-on codes to report fine needle aspiration for each additional lesion targeted, beyond the first, depending on whether imaging guidance is used—and, if so, which type (ultrasound, fluoroscopy, CT, or MR).
You will be able to “mix and match” the primary and add-on codes in any combination necessary to report medically-necessary services, as provided. For example, you could report FNA of an initial lesion using CT guidance, along with an add-on code to report FNA of one additional lesion without guidance.
In every case, however, you may report only one primary (“initial lesion”) code, and you’ll have to append modifier 59 Distinct procedural service to any add-on (“each additional lesion”) codes reported, if the add-on code(s) and the initial code describe different types of imaging (for example, when reporting FNA of an initial lesion using CT guidance, and FNA of an additional lesion using MR, ultrasound, fluoroscopy, or no guidance).
Additionally, you may not separately report imaging with any of the new FNA codes.
For more information on the fine needle aspiration coding in 2019, and a complete rundown of the new, revised, and deleted codes and guidelines in CPT® 2019, be sure to catch AAPC’s comprehensive, four hour 2019 CPT Coding Updates Virtual Workshop on December 6 (by demand starting 12/7), presented by AAPC’s own Raemarie Jimenez, CPC, CPMA, CPC-I, CANPC, CRHC. Or, join Raemarie on Nov. 20 for a one-hour webinar that highlights the changes you can expect in CPT® 2019.