Radiology Coding Alert

Question: The radiologist first used an anterior approach (19-gauge coaxial needle) to a liver lesion, but determined he could not perform the percutaneous needle biopsy from that approach. He then used an oblique approach and took four core specimens from the liver mass. He documented CT guidance. The pathology report documented that the lesion was benign hepatic adenoma. How should I code this report?Colorado SubscriberAnswer: The appropriate code for the needle biopsy is 47000 (Biopsy of liver, needle; percutaneous). Tip: CPT® 2012, effective Jan. 1, 2012, adds the moderate sedation symbol to 47000, meaning that the liver biopsy service includes conscious sedation as part of providing the procedure. As a result, the physician who performs the liver biopsy should not separately report 99143-+99145 (Moderate sedation services ...) for services on or after Jan. 1.In addition to 47000, because the physician documents CT guidance, you should report 77012 (Computed tomography guidance [...]