Code 76942

Mklaubauf

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If we do a puncture aspiration of a breast cyst(19100) with ultrasound guidance(76942) and in a different area of same breast we do a Vacora biopsy(19103 w/ultrasound guidance(76942)

Can I code for two ultrsounds ?
Marci Klaubauf,
 

ciphermed

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Although I predominatly code for facility I think this still applies...
The CMS CCI manual version 14.3 Chap IX Radiology Services CPT codes 70000-79999
radiolological guidance CPT codes (76942, 77002, 77003, 77012 & 77021)
"CMS payment policy allows one unit of service for any of these codes at a single patient encounter regardless of the number of needle placements performed. The unit of service for these codes is the patient encounter, not the number of lesions, number of aspirations, number of biopsies, number of injections, or number of localizations.

http://www.cms.hhs.gov/NationalCorrectCodInitEd/01_overview.asp#TopOfPage

Hope this helps,
 

chembree

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If we do a puncture aspiration of a breast cyst(19100) with ultrasound guidance(76942) and in a different area of same breast we do a Vacora biopsy(19103 w/ultrasound guidance(76942)

Can I code for two ultrsounds ?
Marci Klaubauf,
I have an AMA CPT tip of the day calendar and it says…

When coding image-guided core needle biopsies of the breast, if multiple tissue samples are removed from one lesion, one code (19100) and one localization code (77031) are reported. If separate, multiple lesions are present, report biopsy code (19100) more than once, with modifier 51 appended to indicate the number of subsequent biopsies. If separate localization is performed for multiple lesions, report code 77031 for each separate localization with modifier 51.

This was issued on April 23rd by the AMA. I know these are not the same exact codes but it may give you some idea. Also judging by the previous posters response it may depend on the insurance.

Hope this help,
Christy- CPC
 
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