Radiology Coding Alert

Test your coding knowledge. Determine how you would code this situation before looking at the box below for the answer.

Question: How do I code radio frequency tumor ablation procedures? Do I assign both a procedural and a supervision and interpretation (S&I) code?

Florida Subscriber

  Answer: Unfortunately, no CPT Codes describe radio frequency tumor ablation (RFA). Some coding experts have recommended 49200 (excision or destruction by any method of intra-abdominal or retroperitoneal tumors or cysts or endometriomas) and 49201 ( extensive) for lesions in the abdomen or retroperitoneum. Depending on the payer, this code may be reimbursed because its definition clearly states any method.

However, for removal of lesions elsewhere in the body, coders should assign an unlisted procedure code. The specific code will depend on the area of the body being treated (e.g., 32999, unlisted procedure, lungs and pleura).

The appropriate S&I code assigned to describe the imaging guidance depends on the modality used to guide the RFA (e.g., for CT use 76360, computerized tomography guidance for needle placement [e.g., biopsy, aspiration, injection, localization device], radiological supervision and interpretation; or for ultrasound use 76942, ultrasonic guidance for needle placement [e.g. biopsy, aspiration, injection, localization device], imaging supervision and interpretation).

New codes for the description of these procedural and S&I services are expected in 2002.