AAPC - Back to school
Results 1 to 9 of 9

Thread: Biopsy with US guidance

  1. #1

    Default Biopsy with US guidance

    AAPC: Back to School
    Is 76942 billable with 19102? Or is the guidance bundled into 19102?

    Thanks for any help!

  2. #2


    If it is ultrasound guidance you can. Guidance is not bundled into breast bx.

  3. #3
    Join Date
    Apr 2007
    Kokomo, IN

    Default biopsy with guidance

    I would say it's bundled:
    19102 has the wording "with imaging guidance" in the description so it's not separately reportable.

  4. #4


    76942 and 19102 appear to be billable together. There are no conflicting edits on them being billed together and if you look at encoder it crosswalks you to the guidance codes in addition to the biopsy.

  5. #5
    Join Date
    Apr 2007
    Kokomo, IN

    Default biopsy

    Coding and reporting image-guided breast biopsies

    The Centers for Medicare & Medicaid Services (CMS) recently published instructions for coding and reporting percutaneous image-guided breast biopsies in program memorandum (PM) AB-02-128.

    According to the PM, Medicare covers services provided for percutaneous image-guided breast biopsies. The image guided systems may be either ultrasound or stereotactic. Coverage is provided for a radiographic nonpalpable abnormality that is graded based on the Breast Imaging Reporting and Data System (BIRADS) as probably benign, a suspicious abnormality, or an abnormality. Medicare will also cover palpable lesions that are difficult to biopsy using palpation alone.

    The applicable CPT codes listed in this PM for facility reporting are:

    · 19102, percutaneous needle core, using imaging guidance

    · 19103, percutaneous automated vacuum assisted or rotating biopsy device, using imaging guidance

    · 10022, fine needle aspiration; with imaging guidance

    NOTE: For imaging guidance performed in conjunction with 19102, 19103 see codes 76095, 76096, 76360, 76393 and 76942.

    This is from coding clinic, so I stand corrected. They are separately billable. Thanks for making me check again!

  6. #6


    whew...I was thinking I'd have to let some people know that they've been billing them wrong! good to know they're good

  7. #7


    CPT 76942 can be billed with 19102.It is not a bundled procedure.

  8. #8
    Join Date
    Apr 2007


    I have been coding for radiology and i do bill 76942 and 19102 together. It has never been denied so far.

  9. #9

    Default CPT 76942 and 19103

    If the hospital owns the portable ultrasound machine - and the surgeon does the breast biopsy in his office can he bill for the 76942 plus the 19103. I know it is possible in the hospital setting but not sure if the surgeon can from his office since the equipment is not owned by that facility


Similar Threads

  1. Breast biopsy w/stereotactic guidance
    By LJ in forum Billing/Reimbursement
    Replies: 0
    Last Post: 03-13-2014, 11:50 AM
  2. 2014 breast biopsy - guidance only
    By JREDLINE in forum Interventional Radiology
    Replies: 2
    Last Post: 01-28-2014, 05:54 PM
  3. Biopsy with image guidance *******
    By torresreb in forum Medical Coding General Discussion
    Replies: 0
    Last Post: 09-12-2012, 03:03 PM
  4. Question US Guidance Needle Biopsy?
    By jifnif in forum Medical Coding General Discussion
    Replies: 4
    Last Post: 03-30-2008, 06:41 AM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts

Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.