• If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten the password it can be reset on our sign in section by entering your registered Email Address or Username here. To start viewing messages, select the forum that you want to visit from the selection below..

Wiki Ultrasound guided breast biopsy with multiple lesions

Messages
2
Location
Panama City, FL
Best answers
0
Please advise how you would code this for MEDICARE:
EXAM:
MAMMOGRAM BILATERAL POST BIOPSY; ULTRASOUND GUIDED BREAST BIOPSY ADDITIONAL SITE; ULTRASOUND GUIDED BREAST BIOPSY BILATERAL

HISTORY:
Bilateral abnormalities identified on outside diagnostic MRI. Second-look ultrasound reveals multiple findings warranting further evaluation with ultrasound-guided core biopsy, detailed below.

PROCEDURE:
The details of the procedure were discussed with the patient and the risks, benefits and alternatives were explained. Her consent was documented.

Sample A right breast 8 oclock: The skin was prepped in the usual sterile fashion. The lesion at 8 oclock was located with direct ultrasound visualization. The skin and deeper tissues were anesthetized with 1% Xylocaine and a 14 gauge biopsy needle was advanced to the lesion through a small skin incision. 5 samples were obtained and sent to pathology in formalin. A linear, stoplight shaped metallic marker was left at the biopsy site. Hemostasis was achieved with several minutes of manual compression. The patient tolerated the procedure well.

Sample B palpable mass left breast 3 oclock: The skin was prepped in the usual sterile fashion. The lesion at 3 oclock was located with direct ultrasound visualization. The skin and deeper tissues were anesthetized with 1% Xylocaine and a 14 gauge biopsy needle was advanced to the lesion through a small skin incision. 6 samples were obtained and sent to pathology in formalin. A linear, stoplight shaped metallic marker was left at the biopsy site. Hemostasis was achieved with several minutes of manual compression. The patient tolerated the procedure well.

Sample C left breast 1 oclock: The skin was prepped in the usual sterile fashion. The lesion at 1 oclock was located with direct ultrasound visualization. The skin and deeper tissues were anesthetized with 1% Xylocaine and a 14 gauge biopsy needle was advanced to the lesion through a small skin incision. 3 samples were obtained and sent to pathology in formalin. A ribbon shaped metallic marker was left at the biopsy site. Hemostasis was achieved with several minutes of manual compression. The patient tolerated the procedure well.

Sample D left breast 2 oclock: The skin was prepped in the usual sterile fashion. The lesion at 2 oclock was located with direct ultrasound visualization. The skin and deeper tissues were anesthetized with 1% Xylocaine and a 14 gauge biopsy needle was advanced to the lesion through a small skin incision. 6 samples were obtained and sent to pathology in formalin. A X shaped metallic marker was left at the biopsy site. Hemostasis was achieved with several minutes of manual compression. The patient tolerated the procedure well.

POST BIOPSY MAMMOGRAM: CC and ML views of the both breasts demonstrate for new biopsy markers. In the right breast, the stoplight shaped marker corresponds to sample A at 8 oclock. On the left, the stoplight shaped marker corresponds to biopsy site B at 3 oclock. The ribbon shaped marker at 1 oclock corresponds to biopsy site C in the X shaped biopsy marker at 2 oclock corresponds to biopsy site D. There is no significant post-biopsy hematoma at any of the biopsy sites.

IMPRESSION:
Uncomplicated bilateral breast ultrasound guided core biopsies. Pathology is pending.
 
I coded it as 19083 RT; 19084 LT; 19084 59LT; 19084 59LT. Medicare denied the 3 19084s for: Payer deems the information submitted does not support this many frequency of services. I told my billing manager to appeal it and send the report showing that a total of 4 lesions were biopsied. She chose to change the codes to: 19083 50, 19084 LT and 19084 XULT. What would you do?
 
Top