Radiology Coding FNA vs Core Biopsy

dbwise

New
Messages
4
Location
San Antonio, Texas
Best answers
0
I am auditing coding for interventional radiology biopsies using the new 2019 guidelines. When I pulled the pathology reports, the pathologist is stating the specimen they received was a fine needle aspirate yet the radiologist states the sample was a core needle biopsy and I should not rely on the pathology report. The radiologist wants to use the core biopsy coding with guidance and states not to use the new inclusive coding for FNA biopsies. Researching the new coding guidelines I have found very little information that state how this should be coded when the reports obviously do not match. Any help?
 

thomas7331

True Blue
Messages
2,280
Best answers
5
I often see FNA on pathology reports when the radiology report clearly shows that it is a core biopsy and not a FNA - I'm not sure why this happens, whether due to a mislabeling of specimens, or due to incorrect usage of the term by the pathologists. In any case, there is guidance from CPT on this with the 2019 revision (quoted below). We've also been given written guidance that FNA samples are done by needles of 20 gauge or higher - core biopsies use 14-18 gauge. Our radiology reports typically reflect that, in addition to being a 'core' biopsy, the physicians are not using fine needles to do the procedure, so I am comfortable coding according that even if the pathology reports contradicts it.

A fine needle aspiration (FNA) biopsy is performed when material is aspirated with a fine needle and the cells are examined cytologically. A core needle biopsy is typically performed with a larger bore needle to obtain a core sample of tissue for histopathologic evaluation.
 
Messages
185
Best answers
0
I often see FNA on pathology reports when the radiology report clearly shows that it is a core biopsy and not a FNA - I'm not sure why this happens, whether due to a mislabeling of specimens, or due to incorrect usage of the term by the pathologists. In any case, there is guidance from CPT on this with the 2019 revision (quoted below). We've also been given written guidance that FNA samples are done by needles of 20 gauge or higher - core biopsies use 14-18 gauge. Our radiology reports typically reflect that, in addition to being a 'core' biopsy, the physicians are not using fine needles to do the procedure, so I am comfortable coding according that even if the pathology reports contradicts it.

A fine needle aspiration (FNA) biopsy is performed when material is aspirated with a fine needle and the cells are examined cytologically. A core needle biopsy is typically performed with a larger bore needle to obtain a core sample of tissue for histopathologic evaluation.
 
Messages
185
Best answers
0
Agree with Thomas.....go by what is documented in your report.....it's it's an FNA, the body of the report will support that, and if it's a core needle bx., same.....I would go by the documentation in the report, not the pathology report.
 
Top