Wiki Device Code for CPT 19281

[gabetteyoung@yahoo.com]

I recently coded an incisional breast biopsy (19101) with 19281 for the mammographic needle location of microcalcifications. Aetna is denying the claim stating that 19281 requires a device code. I am not sure what device code is needed or where to find it. I would appreciate any assistance. Thank you!

 

[thomas7331]

The device edit should apply to the facility claim only, and would be for the needle localization device as indicated in the descriptor for 19281. Most facilities would hard-code the HCPCS for the device into the facility charge master so that the code would appear when OR staff scanned the device onto the patient's account and it wouldn't be up to the coder to add this. Does your facility have a process for you to return the account to the OR so that they can add the device charge for you?

 

[gabetteyoung@yahoo.com]

The device edit should apply to the facility claim only, and would be for the needle localization device as indicated in the descriptor for 19281. Most facilities would hard-code the HCPCS for the device into the facility charge master so that the code would appear when OR staff scanned the device onto the patient's account and it wouldn't be up to the coder to add this. Does your facility have a process for you to return the account to the OR so that they can add the device charge for you?

Thank you, Thomas! I didn't think it would be something I would add, but the billing department sent it to me so I was trying to get as much information as possible so I would know who actually would add this. Yes, I can return this to the OR department and have them add it. I really appreciate your help!