General Surgery Coding Alert
Modifier -26 and FNA Codes
Question: Why are our claims for fine needle aspiration (FNA) performed in the office being denied? Ohio Subscriber Answer: FNA is reported using 10021 or 10022. These codes were introduced in CPT 2002 to replace 88170 and 88171. However, 10021 and 10022 retained the characteristics of the two earlier codes: This includes the fact that each could be divided into professional and technical components, despite the fact that the technical component only covered provision of supplies (i.e., slide and needle) for the service. Medicare issued a transmittal (AB-02-018) in February 2002 that ended this division. Modifiers -26 (Professional component) and -TC (Technical component) no longer apply to 10021 and 10022 and should not be appended, even if the procedure was performed in the hospital and the surgeon did not pay for the supplies. It may be that the carrier is denying FNA because a modifier has been appended inappropriately. Otherwise, the claims should not be rejected (assuming they are documented appropriately), and any denials should be appealed.
General Surgery Coding Alert
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Modifier -26 and FNA Codes
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