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Pathology/Lab Coding Alert

You Be the Coder:

88172, 88333 Bundling Hurdles Abound

Published on Fri Jan 14, 2011

Question: I'm concerned about bundling rules for FNA and core biopsy performed together. If our pathologist examines an FNA and performs touch preps on a core biopsy for the same patient on the same day, how should we code the case? Answer: Pathologists sometimes evaluate FNA specimens intraoperatively so the surgeon can use the findings to determine the need for additional aspirations from the same lesion, or for a more complex procedure like a needle-core biopsy. Your stated bundling concern may relate to the fact that the Correct Coding Initiative (CCI) Policy Manual states that you should not report together a fine needle aspiration (FNA) (10021-10022, Fine needle aspirate; ...) and biopsy (such as 19100, Biopsy of breast; percutaneous needle core, not using imaging guidance [separate procedure]) from the same lesion unless one specimen is inadequate for diagnosis. But that restriction primarily constrains the surgeon. Your pathologist must depend on [...]
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