I have just learned of a new arrangement the ASC I code for has entered into. I hope that someone out there has experience with this senario.

The company shows up and brings the equipement and the technical staff, a fee is paid to them per case.

The surgeon is there and he/she does the procedure and dictates a report. This is ASC Facility Billing Only. The ASC is licensed as an ASC and IDTF from what I am told. My question is on the coding for this and the place of service. I am thinking this should be POS 24 for all coding. Here is the report. I am having confusion about the IDTF part of this, for the radiology codes. Opinion/references are appreciated.

Procedure: Ultrasound guided vacuum assisted mammotome biopsy of right breast mass.

Operative Procedure: The breast mass was localized on ultrasound and compared to previous films and was thought to be concordant. Local anesthesia with 1% lidocain with epinephrine was infiltrated. A small stab incision was made. The mammotome biopsy needle was advanced to the lesion. Good placement was confirmed on ultrasound. Three cores were obtained. In doing so, it appeared that the lesion completely disappeared as it appeared to be a complex cyst. A clip was placed in the area.

I am thinking: 19103, 76942-TC, 76645-TC, 19295. Please advise on what your thoughts are, Thank You in advance, I appreciate your opinion and expertise.