Q: With the new code for lung core needle biopsy, which bundles imaging, how do we code for fine needle aspiration (FNA) performed in the same encounter when imaging is used for it?
A: New code 32408 for core needle biopsy of the lung bundles all FNA codes. According to the NCCI edits, if the same lesion is biopsied with FNA followed by core needle biopsy, only one of the biopsy codes can be reported. If a core biopsy is performed and FNA is performed on a separate lesion, report both 32408 and the appropriate code for FNA, depending on the method of imaging guidance and append modifier 59 (or XS) to the FNA code to show that it was performed at a different site.
Q: Is there any NCCI edit available for loose body removal?
A: Codes for loose body removal are already bundled into several arthroscopy codes. Some of the code pairings allow for a modifier to be added to show that the loose body was separate from the arthroscopic procedure while others do not.
Kristi Pollard, RHIT, CCS, CPC, CIRCC, AHIMA-Approved ICD-10-CM/PCS Trainer
Kristi has served the Colorado Health Information Management Association (CHIMA) as board Director, co-chair of the Data Quality Committee, and co-chair for the ICD-10 Task Force. She is also a past president of the Northern Colorado Health Information Management Association (NCHIMA). Kristi is the proud recipient of the 2011 AHIMA Triumph Award for Mentoring for her voluntary work as the “Coder Coach.” She has also received awards from CHIMA for Distinguished Member (2018) and Outstanding Volunteer (2013) and from AHIMA for Roundtable Achievement in Coding Excellence (RACE).