a. 10022 is for fine needle percutaneous aspiration with guidance. If the report doesn't say "fine needle" you cannot use this code-regardless of what size guage is used. So for this one, I would use 10160 plus your guidance code if they used guidance.
b. is this done percutaneously or through an incision? If done through an incision I would use either 58800 or 58805(depending on the approach). If it was done percutaneously, unfortunately there isn't yet a code that exists for a percutaneous ovarian cyst aspiration so you would have to use 10160 because this is the closest you can get. You wouldn't use 49021 because this is only for abscesses of the peritoneal (or abdomen).
cpt 20000 is for use when an incision is done of a soft tissue abscess, superficial....meaning this is on the skin.....so ovary definately wouldn't fall into this.
Do you code a lot of interventional procedures? If so, I would recommend the Interventional Radiology Coder book by MedLearn (it's a good reference for interventionals that I would highly recommend!)
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