Wiki Billing for Fine Needle Aspiration

[Andrea Bowers]

I need some coding help. I am having trouble getting paid for fine needle aspiration (10022) and ultrasonic guidance for needle placement (76942) on multiple nodules. We used to bill with multiple units on one line item each and claims paid. Now some of the payers are saying that each unit should be billed on separate line with appropriate modifiers. Plus, we have some that require 76942 to be billed all on one line with multiple units, and 10022 to be billed on multiple lines!!!! We are getting frustrated with the denials and the provider is getting hot under the collar with us.

What is the correct way to be billing these 2 codes when you have multiple nodules being aspirated?

Thanks.

Andrea Bowers, CMM, CPC

 

[mitchellde]

units are designed to be use for services that come as a quantity distribution like timed codes and drugs. Surgical procedure and radiology do not come as quantities each nodule is separate and distinct so if you perform an aspirate of 3 nodules you indicate 3 distinct and separte procedure with a new line item and a 59 modifier. The same should be true for the guidance, but i do not have a book handy. It will depend on the code descriptor.