ED Coding and Reimbursement Alert

Question: The ED physician performs puncture aspiration on a solitary cyst in a patient’s right breast. During the aspiration, the physician used ultrasound (US) guidance for needle placement. How should I report this encounter?

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Answer: Yes, you can code for the US guidance. On the claim, report:

• 19000 (Puncture aspiration of cyst of breast) for the puncture aspiration
• 76942 (Ultrasonic guidance for needle placement (eg, biopsy, aspiration, injection, localization device), imaging supervision and interpretation) for the US guidance
• N60.01 (Solitary cyst of right breast) appended to 19000 and 76942 to represent the patient’s condition.