Wiki Codes 19290 and 19295 Needle Intro codes

[SharL]

This is the closest forum to diagnostic radiology, so I'm posting this here in hopes to get some feedback: When coding Needle localization in a breast biopsy case, somewhere I read (I think in an audio handout) that the 19295 (image guided placement of tissue marker/clip) is rolled into the 19290 (placement of needle localization wire) so you cannot code it together, yet CPT does not say you cannot code it together.

Can anyone comment on these two codes ?

 

[smwaters]

Not sure if you're still looking for an answer, but I ran them through CCI Tools and there was a conflict stating: "...may be reported together if documentation supports that the procedures are separate" and "19290 Supercedes the M.E. Code 19295"

 

[ajhernandez]

Shar - CPT 19295 is exclusionary and should only bill it during a breast biopsy (19102 or 19103) unless of course the wire loc and clip placement w/biopsy are separate encounters on same DOS (then you could try a 59 mod). A similar question as yours was asked on another radiology coding forum and the answer was to try coding 19290-22. A lot of extra work with a 22 modifier, but maybe that is what your physicians want? Hope this helps. AJ

 

[SharL]

Thanks so much for the feedback, yes, I think documentation is key and the 59 would probably have to be added We just had a new scenario this week. The radiologists are now doing a clip placement +19295 with "aspirations" (19000). Do you know if that can be coded along with a non-biopsy code ? We've never billed those together before. . . but it has never been done before either.