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Coding Dual Procedures

Coding Dual Procedures

If you have a core biopsy and an FNA (Fine Needle Aspiration) performed on the same day, your CMS manual states you cannot report fine needle aspiration (FNA) codes 10021 and 10022 with another biopsy procedure code for the same lesion.

A good example of this is when a physician performs an FNA and core biopsy for the same breast lesion during the same encounter, but does not document that the FNA sample was inadequate for diagnosis. The physician performed the services described by 10022 (Fine needle aspiration; with imaging guidance), 19102 (Biopsy of breast; percutan-eous, needle core, using imaging guidance), and 76096 (Mammographic guidance for needle placement, breast [e.g., for wire localization or for injection]). The National Correct Coding Initiative edits bundle 10022 into 19102. If you report them both, you will receive a denial for 10022. Instead, report 19102 and 76096.

However, and this occurs rarely, you can report them together if you have both medical-necessity and documentation of complaints leading up to the need for the FNA procedure. Since different gauge needles are used to the procedure, there is no limitation to the size of the needle used for the FNA to be reported as 10022.

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