Radiology Coding Alert

Question: Whats the difference between aspiration and biopsy?

Ohio Subscriber  
Answer: Part of the confusion is that radiologists use the terms interchangeably, and the terms arent clearly explained in the CPT manual, or in other coding guides available.
 
Simply put, aspiration describes the process of withdrawing fluid, gas, tissue or free-floating cellular material via suction. This withdrawing of fluid through a needle, called fine-needle aspiration (FNA), can be done for several reasons, one of which is to perform cytology on the fluid looking for malignant cells. The term fine needle is a misnomer because the size of the needle varies.
 
Biopsy, often considered a more general term, describes a variety of means of removing fluids or tissue. Biopsy methods include excision, when the physician creates a surgical opening to remove the tissue, and core, when the physician uses a hollow needle inserted into the infected area to remove a sample of tissue (core). Nearly all needle biopsies (core) obtain a core of tissue in addition to, or in place of, an aspiration. Therefore, most percutaneous needle procedures conducted to obtain tissue from a solid or semisolid organ or mass are biopsies, not simple aspirations. But, aspirations are frequently performed to assess whether fluid collections are infected, benign or malignant.
 
In most instances, FNA and core would be the only types of biopsies a radiology coder would encounter. A surgeon generally performs excisional biopsies.