Wiki Fine Needle Aspiration performed by the Pathologist versus a cytotechnician

danachock

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Good evening, Pathology Colleagues,
What a fantastic week so far! I will be completely honest and share that I have seen a few new things I am not acclimated with and was hopeful with your help (my colleagues) that you may offer some advice please.

I have a few questions regarding an "in house" fine needle aspiration (FNA) performed by the pathologist or by the cytotechnician for a procedure.

For the pathologist performing a FNA (fine needle aspiration). Are these (FNA = fine needle aspiration) charges dropping into your work queue for review? Or are you expected to add these necessary charges to the other pathology charges for that DOS (day of service) based on the pathology report like in a router work queue? OR - is that charge (or possible charges - based on the event) part of an entirely different accession that someone else assigns the(se) charge(s)?

If your pathologist doesn't perform the FNA (fine needle aspiration) and let's say the cytotechnician or cytotechnologist (or anyone not pathology related) performs the FNA (fine needle aspiration) - who ultimately drops that charge? Is it (again) on a different accession and someone else populates and codes that procedure, or is it automatically dropped to the HB HAR (or possibly PB HAR based on insurance) with the assigned diagnosis code from the lab order, or is it ultimately the sole responsibility of the pathology coder to populate this charge or charge(s) after reviewing the pathology report to determine if one or more passes were performed utilizing US guidance or not?

I know that we can bill 88172TC only but what about "add on" 88177 for the adequacy if the first (or subsequent) attempt(s) wasn't adequate. I would like to assume we can, but I would like to cover my basis and ask all my questions upfront for this discussion please.

If any of my colleagues has any experience with FNA (fine needle aspirations) performed by the pathologist, I would love to hear your insight. Again, even if your pathology department doesn't perform any FNAs (fine needle aspirations) I would love to hear your responses on how "it should be coded".

I do apologize for my lengthiness on this post this evening. but again, I completely appreciate any insight my colleagues have to provide on this FNA (fine needle aspiration) process.
I hope everyone has a fantastic evening!!
Dana Chock
 
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