Radiology Coding Alert

Question: Because the descriptor for breast biopsy code 19102 states, "using imaging guidance," one of our physicians believes that we should not separately report the guidance code 76942. I couldnt find any National Correct Coding Initiative (NCCI) edits that bar us from reporting these codes together, so how should we report these services? Texas Subscriber Answer: According to the January 2001 CPT Assistant, "New CPT code 19102 is intended to report image-guided percutaneous needle core biopsy crossreferences were added following codes 19102 and 19103 to direct users to the appropriate radiology codes for image guidance, when performed." Thus, you can report 19102 (Biopsy of breast; percutaneous, needle core, using imaging guidance) and 76942 (Ultrasonic guidance for needle placement [e.g., biopsy, aspiration, injection, localization device], imaging supervision and interpretation) together. Your radiologist may not have noticed the parenthetical note in CPT that states, "For imaging guidance performed in conjunction with 19102, 19103, see 76095, 76096, 76360, 76393, 76942," because it appears after the descriptor for 19103 (Biopsy of breast; percutaneous, automated vacuum assisted or rotating biopsy device, using imaging guidance) instead of 19102. If you perform mammographic guidance with the biopsy, you should report 76096 (Mammographic guidance for needle placement, breast [e.g., for wire localization or for injection], each lesion, radiological supervision and interpretation). Although CPT does not include a notation following 19102 that offers this advice, CPT Assistant recommends that you bill this way, as does a parenthetical note following 76096.