SlideShare a Scribd company logo
1 of 2
THYROID FINE NEEDLE ASPIRATION vs THYROID BIOPSY
        Quick Look:

             •    Explain the variances between Thyroid Nodule FNA and Thyroid Biopsy
             •    CPT code choice 10022 or 60100
             •    Report example of conflicting verbiage

        Selecting the correct CPT code choice when reviewing documentation for biopsies and FNA’s are
        dependent on the description provided by the physician. If the documentation supports the verbiage of
        a biopsy, we will code 60100. If it supports an aspiration, we will assign 10022. Often times the
        radiologist will use the terms FNA and biopsy interchangeably when reporting these services. Due to the
        different CPT code choices, conflicting documentation can make code assignment difficult for the coder.
        Though the basic rules apply to all biopsies and FNA’s, we typically experience the biggest problem with
        thyroid procedures. In an effort to improve documentation and streamline the code choice, I am
        supplying coding guidelines that apply to these procedures.


                       FNA                                                           Thyroid biopsy
    10022 ~ Fine needle aspiration with imaging
                     guidance                                      60100 ~ Biopsy thyroid, percutaneous core needle
                                                              A needle core biopsy is most often performed using a large-
FNA is typically performed with a small-gauge needle          gauge cutting needle

FNA's are routinely sent to pathology for cytology            Biopsies are sent to pathology for histology
Cytology is often immediately available for
interpretation                                                Histology is processed overnight
FNA can be reported once for each lesion that is
aspirated                                                     Needle core biopsy codes are reported once per lesion
Multiple passes with the needle into the same lesion          If multiple specimens are taken from the same lesion, only
is considered to be a single FNA                              one biopsy procedure should be reported


        Additional coding information:
        • The coder is instructed NOT to use the size of the needle to distinguish between needle core biopsy
           and FNA
        • According to CPT, the imaging guidance code should be reported once for each lesion or area
        • Medicare allows only one unit of service for the guidance regardless of the number of needle
           placements performed
        • Codes for both a biopsy and a needle aspiration cannot be billed together at the same session unless
           documentation supports inadequate specimen sampling by pathology with one technique (usually
           the FNA) requiring the other technique (usually the core biopsy) to obtain adequate material.
        • If documentation is unclear, the radiologist needs to be asked to clarify the technique in an
           addendum

        T. Galan                                        -1-                               Thyroid FNA vs Biopsy
        HIS-South, Radiology Division                                                     February 3, 2011
CONFLICTING REPORT EXAMPLE

Ultrasound guided thyroid biopsy.

History: Thyroid nodule.

Comparison: None.

Findings:
There are two large nodules that are heterogeneous and solid in the left thyroid lobe. Physician orders
state to biopsy the larger lower pole nodule in the left thyroid lobe. The risks and benefits of the
procedure including, infection, bleeding, injury to surrounding structures was discussed with the patient.
The patient gave informed consent. A timeout was performed to verify the site of procedure, type of
procedure and patient identification. The patient was prepped and draped in a sterile manner. 1%
Lidocaine was used for local anesthesia. Three samples of the lower pole large solid 2.3 cm nodule was
obtained by ultrasound guidance using a 25-gauge needle. These 3 fine-needle aspirates were
considered adequate by pathology at the bedside. No immediate complications.

Impression:
Successful fine needle aspiration of lower pole solid left thyroid lobe nodule.




T. Galan                                         -2-                              Thyroid FNA vs Biopsy
HIS-South, Radiology Division                                                     February 3, 2011

More Related Content

What's hot

Piles Types, Causes and Symptoms | Piles Laser Treatment in Hyderabad
Piles Types, Causes and Symptoms | Piles Laser Treatment in HyderabadPiles Types, Causes and Symptoms | Piles Laser Treatment in Hyderabad
Piles Types, Causes and Symptoms | Piles Laser Treatment in HyderabadYashodaHospitals
 
Image-guided head and neck biopsy
Image-guided head and neck biopsyImage-guided head and neck biopsy
Image-guided head and neck biopsyThiago Julio, MD
 
Management of salivary gland tumor
Management of salivary gland  tumorManagement of salivary gland  tumor
Management of salivary gland tumorShashank Bansal
 
amputation.pptx
amputation.pptxamputation.pptx
amputation.pptxSuhas U
 
Radiologically guided fnac
Radiologically guided fnacRadiologically guided fnac
Radiologically guided fnacsonali timaniya
 
Abcess+incision+and+drainage
Abcess+incision+and+drainageAbcess+incision+and+drainage
Abcess+incision+and+drainageSharath !!!!!!!!
 
Metastasis of Neck Node with Unknown Primary
Metastasis of Neck Node with Unknown Primary Metastasis of Neck Node with Unknown Primary
Metastasis of Neck Node with Unknown Primary Himanshu Soni
 
Side effects of radiation in head and neck cancer
Side effects of radiation in head and neck cancerSide effects of radiation in head and neck cancer
Side effects of radiation in head and neck cancerAnagha pachat
 
Head and neck; brachytherapy.pptx final
Head and neck;  brachytherapy.pptx finalHead and neck;  brachytherapy.pptx final
Head and neck; brachytherapy.pptx finalpgclubrcc
 
Enteroclysis( small bowel enema)
Enteroclysis( small bowel enema)Enteroclysis( small bowel enema)
Enteroclysis( small bowel enema)Ankit Mishra
 
Narrow band imaging
Narrow  band imagingNarrow  band imaging
Narrow band imagingJinu Iype
 
Plaque Radiotherapy for Uveal Melanoma
Plaque Radiotherapy for Uveal MelanomaPlaque Radiotherapy for Uveal Melanoma
Plaque Radiotherapy for Uveal MelanomaYonah Ziemba
 
Radiographic technique of biliary system
Radiographic technique of biliary systemRadiographic technique of biliary system
Radiographic technique of biliary systemInosRagan
 
Management of medullary carcinoma of thyroid - based on latest NCCN and ATA g...
Management of medullary carcinoma of thyroid - based on latest NCCN and ATA g...Management of medullary carcinoma of thyroid - based on latest NCCN and ATA g...
Management of medullary carcinoma of thyroid - based on latest NCCN and ATA g...Sana Sali
 
BRACHYTHERAPY IN ORAL CAVITY
BRACHYTHERAPY IN ORAL CAVITYBRACHYTHERAPY IN ORAL CAVITY
BRACHYTHERAPY IN ORAL CAVITYIsha Jaiswal
 

What's hot (20)

Biopsy seminar
Biopsy seminarBiopsy seminar
Biopsy seminar
 
Piles Types, Causes and Symptoms | Piles Laser Treatment in Hyderabad
Piles Types, Causes and Symptoms | Piles Laser Treatment in HyderabadPiles Types, Causes and Symptoms | Piles Laser Treatment in Hyderabad
Piles Types, Causes and Symptoms | Piles Laser Treatment in Hyderabad
 
Breast Ductography.pptx
Breast Ductography.pptxBreast Ductography.pptx
Breast Ductography.pptx
 
Image-guided head and neck biopsy
Image-guided head and neck biopsyImage-guided head and neck biopsy
Image-guided head and neck biopsy
 
Management of salivary gland tumor
Management of salivary gland  tumorManagement of salivary gland  tumor
Management of salivary gland tumor
 
amputation.pptx
amputation.pptxamputation.pptx
amputation.pptx
 
Radiologically guided fnac
Radiologically guided fnacRadiologically guided fnac
Radiologically guided fnac
 
Lasers in surgery
Lasers in surgeryLasers in surgery
Lasers in surgery
 
Breast biopsy ppt
Breast biopsy pptBreast biopsy ppt
Breast biopsy ppt
 
Abcess+incision+and+drainage
Abcess+incision+and+drainageAbcess+incision+and+drainage
Abcess+incision+and+drainage
 
Metastasis of Neck Node with Unknown Primary
Metastasis of Neck Node with Unknown Primary Metastasis of Neck Node with Unknown Primary
Metastasis of Neck Node with Unknown Primary
 
Side effects of radiation in head and neck cancer
Side effects of radiation in head and neck cancerSide effects of radiation in head and neck cancer
Side effects of radiation in head and neck cancer
 
Head and neck; brachytherapy.pptx final
Head and neck;  brachytherapy.pptx finalHead and neck;  brachytherapy.pptx final
Head and neck; brachytherapy.pptx final
 
Enteroclysis( small bowel enema)
Enteroclysis( small bowel enema)Enteroclysis( small bowel enema)
Enteroclysis( small bowel enema)
 
Narrow band imaging
Narrow  band imagingNarrow  band imaging
Narrow band imaging
 
Plaque Radiotherapy for Uveal Melanoma
Plaque Radiotherapy for Uveal MelanomaPlaque Radiotherapy for Uveal Melanoma
Plaque Radiotherapy for Uveal Melanoma
 
Radiographic technique of biliary system
Radiographic technique of biliary systemRadiographic technique of biliary system
Radiographic technique of biliary system
 
BIOPSY
BIOPSYBIOPSY
BIOPSY
 
Management of medullary carcinoma of thyroid - based on latest NCCN and ATA g...
Management of medullary carcinoma of thyroid - based on latest NCCN and ATA g...Management of medullary carcinoma of thyroid - based on latest NCCN and ATA g...
Management of medullary carcinoma of thyroid - based on latest NCCN and ATA g...
 
BRACHYTHERAPY IN ORAL CAVITY
BRACHYTHERAPY IN ORAL CAVITYBRACHYTHERAPY IN ORAL CAVITY
BRACHYTHERAPY IN ORAL CAVITY
 

Viewers also liked

Thyroid Fna,bethesda system
Thyroid Fna,bethesda systemThyroid Fna,bethesda system
Thyroid Fna,bethesda systemKemUnited
 
Ultrasound guided procedures
Ultrasound guided proceduresUltrasound guided procedures
Ultrasound guided proceduresairwave12
 
Reporting thyroid fine needle aspiration by the bethesda system
Reporting thyroid fine needle aspiration by the bethesda systemReporting thyroid fine needle aspiration by the bethesda system
Reporting thyroid fine needle aspiration by the bethesda systemMonika Nema
 
The bethesda system for reporting thyroid cytopathology
The bethesda system for reporting thyroid cytopathologyThe bethesda system for reporting thyroid cytopathology
The bethesda system for reporting thyroid cytopathologyIndira Shastry
 
Breast Surgery Coding 2010
Breast Surgery Coding 2010Breast Surgery Coding 2010
Breast Surgery Coding 2010CZNANIEC
 
The Epidemic of Thyroid Nodules: Which Should Undergo Fine Needle Aspiration?
The Epidemic of Thyroid Nodules: Which Should Undergo Fine Needle Aspiration?The Epidemic of Thyroid Nodules: Which Should Undergo Fine Needle Aspiration?
The Epidemic of Thyroid Nodules: Which Should Undergo Fine Needle Aspiration?u.surgery
 
The bethesda system for reporting thyroid cytopathology
The bethesda system for reporting thyroid cytopathology The bethesda system for reporting thyroid cytopathology
The bethesda system for reporting thyroid cytopathology dhanya89
 
Introduction to procedural ultrasound
Introduction to procedural ultrasoundIntroduction to procedural ultrasound
Introduction to procedural ultrasoundSCGH ED CME
 
color atlas on bethesda system for reporting thyroid cytology
color atlas on bethesda system for reporting thyroid cytologycolor atlas on bethesda system for reporting thyroid cytology
color atlas on bethesda system for reporting thyroid cytologyAshish Jawarkar
 
General characteristics of virus
General characteristics of virusGeneral characteristics of virus
General characteristics of viruskeshav pai
 
Renal biopsy fadl
Renal biopsy fadlRenal biopsy fadl
Renal biopsy fadlAhmed Fadl
 
Carcinoma Of Thyroid Gland
Carcinoma Of Thyroid GlandCarcinoma Of Thyroid Gland
Carcinoma Of Thyroid GlandSaeed Al-Shomimi
 
General properties of viruses
General properties of virusesGeneral properties of viruses
General properties of virusesraghunathp
 
Renal biopsy seminar
Renal biopsy seminarRenal biopsy seminar
Renal biopsy seminarVishal Golay
 

Viewers also liked (20)

Usg guided FNA biopsy
Usg guided FNA biopsyUsg guided FNA biopsy
Usg guided FNA biopsy
 
Thyroid Fna,bethesda system
Thyroid Fna,bethesda systemThyroid Fna,bethesda system
Thyroid Fna,bethesda system
 
Ultrasound guided procedures
Ultrasound guided proceduresUltrasound guided procedures
Ultrasound guided procedures
 
Reporting thyroid fine needle aspiration by the bethesda system
Reporting thyroid fine needle aspiration by the bethesda systemReporting thyroid fine needle aspiration by the bethesda system
Reporting thyroid fine needle aspiration by the bethesda system
 
The bethesda system for reporting thyroid cytopathology
The bethesda system for reporting thyroid cytopathologyThe bethesda system for reporting thyroid cytopathology
The bethesda system for reporting thyroid cytopathology
 
Thyroid gland (functions)
Thyroid gland (functions)Thyroid gland (functions)
Thyroid gland (functions)
 
Rna viruses
Rna virusesRna viruses
Rna viruses
 
Breast Surgery Coding 2010
Breast Surgery Coding 2010Breast Surgery Coding 2010
Breast Surgery Coding 2010
 
The Epidemic of Thyroid Nodules: Which Should Undergo Fine Needle Aspiration?
The Epidemic of Thyroid Nodules: Which Should Undergo Fine Needle Aspiration?The Epidemic of Thyroid Nodules: Which Should Undergo Fine Needle Aspiration?
The Epidemic of Thyroid Nodules: Which Should Undergo Fine Needle Aspiration?
 
The bethesda system for reporting thyroid cytopathology
The bethesda system for reporting thyroid cytopathology The bethesda system for reporting thyroid cytopathology
The bethesda system for reporting thyroid cytopathology
 
Introduction to procedural ultrasound
Introduction to procedural ultrasoundIntroduction to procedural ultrasound
Introduction to procedural ultrasound
 
color atlas on bethesda system for reporting thyroid cytology
color atlas on bethesda system for reporting thyroid cytologycolor atlas on bethesda system for reporting thyroid cytology
color atlas on bethesda system for reporting thyroid cytology
 
General characteristics of virus
General characteristics of virusGeneral characteristics of virus
General characteristics of virus
 
dna and rna Viruses
dna and rna Viruses dna and rna Viruses
dna and rna Viruses
 
Renal biopsy fadl
Renal biopsy fadlRenal biopsy fadl
Renal biopsy fadl
 
Carcinoma Of Thyroid Gland
Carcinoma Of Thyroid GlandCarcinoma Of Thyroid Gland
Carcinoma Of Thyroid Gland
 
Fnac breast
Fnac breastFnac breast
Fnac breast
 
General properties of viruses
General properties of virusesGeneral properties of viruses
General properties of viruses
 
Renal biopsy seminar
Renal biopsy seminarRenal biopsy seminar
Renal biopsy seminar
 
Solitary Thyroid Nodule
Solitary Thyroid NoduleSolitary Thyroid Nodule
Solitary Thyroid Nodule
 

Similar to Thyroid fine needle aspiration vs. thyroid biopsy

Adrian Sultana clinical use of the bar monitor
Adrian Sultana clinical use of the bar monitorAdrian Sultana clinical use of the bar monitor
Adrian Sultana clinical use of the bar monitorLouis Delacretaz
 
Neurologic complications
Neurologic complicationsNeurologic complications
Neurologic complicationsHans Garcia
 
Francesco Procaccio - Italy - Tuesday 29 - Donor Risk
Francesco Procaccio - Italy - Tuesday 29 - Donor RiskFrancesco Procaccio - Italy - Tuesday 29 - Donor Risk
Francesco Procaccio - Italy - Tuesday 29 - Donor Riskincucai_isodp
 
medical thoracoscopy2022
medical thoracoscopy2022medical thoracoscopy2022
medical thoracoscopy2022rambhoopal1
 
2013 4-14 CDO TEPI - thyroid nodules and cancer (Case Based Approach)
2013 4-14 CDO TEPI - thyroid nodules and cancer (Case Based Approach)2013 4-14 CDO TEPI - thyroid nodules and cancer (Case Based Approach)
2013 4-14 CDO TEPI - thyroid nodules and cancer (Case Based Approach)Jeremy F. Robles MD, FPCP, FPSEM
 
SICOT poster 2010 Rev 1F+
SICOT poster 2010  Rev 1F+SICOT poster 2010  Rev 1F+
SICOT poster 2010 Rev 1F+Damjana Derham
 
Sonographic Diagnosis of Abdominal Cutaneous Nerve Entrap- ment Syndrome: A R...
Sonographic Diagnosis of Abdominal Cutaneous Nerve Entrap- ment Syndrome: A R...Sonographic Diagnosis of Abdominal Cutaneous Nerve Entrap- ment Syndrome: A R...
Sonographic Diagnosis of Abdominal Cutaneous Nerve Entrap- ment Syndrome: A R...JohnJulie1
 
Sonographic Diagnosis of Abdominal Cutaneous Nerve Entrap- ment Syndrome: A R...
Sonographic Diagnosis of Abdominal Cutaneous Nerve Entrap- ment Syndrome: A R...Sonographic Diagnosis of Abdominal Cutaneous Nerve Entrap- ment Syndrome: A R...
Sonographic Diagnosis of Abdominal Cutaneous Nerve Entrap- ment Syndrome: A R...JapaneseJournalofGas
 
Dr. gaurav kaushik
Dr. gaurav kaushikDr. gaurav kaushik
Dr. gaurav kaushikULTRAFEST
 
Inguinodynia: Chronic pain after inguinal hernia surgery by Dr. Avisak Bhatta...
Inguinodynia: Chronic pain after inguinal hernia surgery by Dr. Avisak Bhatta...Inguinodynia: Chronic pain after inguinal hernia surgery by Dr. Avisak Bhatta...
Inguinodynia: Chronic pain after inguinal hernia surgery by Dr. Avisak Bhatta...abhishak bhattacharjee
 
12.15 12.30 lynn hadaway - publiceren
12.15 12.30 lynn hadaway - publiceren12.15 12.30 lynn hadaway - publiceren
12.15 12.30 lynn hadaway - publicerenWocova
 
From Panels to Genomes with VarSeq: The Complete Tertiary Platform for Short ...
From Panels to Genomes with VarSeq: The Complete Tertiary Platform for Short ...From Panels to Genomes with VarSeq: The Complete Tertiary Platform for Short ...
From Panels to Genomes with VarSeq: The Complete Tertiary Platform for Short ...Golden Helix
 
CTF 2017 Cutaneous Neurofibroma Resource Sage Bionetworks
CTF 2017 Cutaneous Neurofibroma Resource Sage BionetworksCTF 2017 Cutaneous Neurofibroma Resource Sage Bionetworks
CTF 2017 Cutaneous Neurofibroma Resource Sage BionetworksRobert Allaway
 
ENHANCING THE EFFICIENCY OF POST MORTEM DIAGNOSIS BY IMPROVING THE POST MO...
ENHANCING THE EFFICIENCY OF POST MORTEM  DIAGNOSIS BY IMPROVING THE POST MO...ENHANCING THE EFFICIENCY OF POST MORTEM  DIAGNOSIS BY IMPROVING THE POST MO...
ENHANCING THE EFFICIENCY OF POST MORTEM DIAGNOSIS BY IMPROVING THE POST MO...asha ann philip
 

Similar to Thyroid fine needle aspiration vs. thyroid biopsy (20)

Journal club
Journal clubJournal club
Journal club
 
Adrian Sultana clinical use of the bar monitor
Adrian Sultana clinical use of the bar monitorAdrian Sultana clinical use of the bar monitor
Adrian Sultana clinical use of the bar monitor
 
Neurologic complications
Neurologic complicationsNeurologic complications
Neurologic complications
 
Francesco Procaccio - Italy - Tuesday 29 - Donor Risk
Francesco Procaccio - Italy - Tuesday 29 - Donor RiskFrancesco Procaccio - Italy - Tuesday 29 - Donor Risk
Francesco Procaccio - Italy - Tuesday 29 - Donor Risk
 
medical thoracoscopy2022
medical thoracoscopy2022medical thoracoscopy2022
medical thoracoscopy2022
 
2013 4-14 CDO TEPI - thyroid nodules and cancer (Case Based Approach)
2013 4-14 CDO TEPI - thyroid nodules and cancer (Case Based Approach)2013 4-14 CDO TEPI - thyroid nodules and cancer (Case Based Approach)
2013 4-14 CDO TEPI - thyroid nodules and cancer (Case Based Approach)
 
SICOT poster 2010 Rev 1F+
SICOT poster 2010  Rev 1F+SICOT poster 2010  Rev 1F+
SICOT poster 2010 Rev 1F+
 
Sonographic Diagnosis of Abdominal Cutaneous Nerve Entrap- ment Syndrome: A R...
Sonographic Diagnosis of Abdominal Cutaneous Nerve Entrap- ment Syndrome: A R...Sonographic Diagnosis of Abdominal Cutaneous Nerve Entrap- ment Syndrome: A R...
Sonographic Diagnosis of Abdominal Cutaneous Nerve Entrap- ment Syndrome: A R...
 
Sonographic Diagnosis of Abdominal Cutaneous Nerve Entrap- ment Syndrome: A R...
Sonographic Diagnosis of Abdominal Cutaneous Nerve Entrap- ment Syndrome: A R...Sonographic Diagnosis of Abdominal Cutaneous Nerve Entrap- ment Syndrome: A R...
Sonographic Diagnosis of Abdominal Cutaneous Nerve Entrap- ment Syndrome: A R...
 
Dr. gaurav kaushik
Dr. gaurav kaushikDr. gaurav kaushik
Dr. gaurav kaushik
 
Floating anus and testicles secondary to Fournier's gangrene.pptx
Floating anus and testicles secondary to Fournier's gangrene.pptxFloating anus and testicles secondary to Fournier's gangrene.pptx
Floating anus and testicles secondary to Fournier's gangrene.pptx
 
Point of Care NGS in Community Practice
Point of Care NGS in Community PracticePoint of Care NGS in Community Practice
Point of Care NGS in Community Practice
 
Inguinodynia: Chronic pain after inguinal hernia surgery by Dr. Avisak Bhatta...
Inguinodynia: Chronic pain after inguinal hernia surgery by Dr. Avisak Bhatta...Inguinodynia: Chronic pain after inguinal hernia surgery by Dr. Avisak Bhatta...
Inguinodynia: Chronic pain after inguinal hernia surgery by Dr. Avisak Bhatta...
 
12.15 12.30 lynn hadaway - publiceren
12.15 12.30 lynn hadaway - publiceren12.15 12.30 lynn hadaway - publiceren
12.15 12.30 lynn hadaway - publiceren
 
Renal biopsy
Renal biopsyRenal biopsy
Renal biopsy
 
Renal biopsy
Renal biopsyRenal biopsy
Renal biopsy
 
Renal biopsy
Renal biopsyRenal biopsy
Renal biopsy
 
From Panels to Genomes with VarSeq: The Complete Tertiary Platform for Short ...
From Panels to Genomes with VarSeq: The Complete Tertiary Platform for Short ...From Panels to Genomes with VarSeq: The Complete Tertiary Platform for Short ...
From Panels to Genomes with VarSeq: The Complete Tertiary Platform for Short ...
 
CTF 2017 Cutaneous Neurofibroma Resource Sage Bionetworks
CTF 2017 Cutaneous Neurofibroma Resource Sage BionetworksCTF 2017 Cutaneous Neurofibroma Resource Sage Bionetworks
CTF 2017 Cutaneous Neurofibroma Resource Sage Bionetworks
 
ENHANCING THE EFFICIENCY OF POST MORTEM DIAGNOSIS BY IMPROVING THE POST MO...
ENHANCING THE EFFICIENCY OF POST MORTEM  DIAGNOSIS BY IMPROVING THE POST MO...ENHANCING THE EFFICIENCY OF POST MORTEM  DIAGNOSIS BY IMPROVING THE POST MO...
ENHANCING THE EFFICIENCY OF POST MORTEM DIAGNOSIS BY IMPROVING THE POST MO...
 

More from ReimbursementMD

Protecting and Maximizing Your Orthopedic Revenue Cycle in 2014
Protecting and Maximizing Your Orthopedic Revenue Cycle in 2014Protecting and Maximizing Your Orthopedic Revenue Cycle in 2014
Protecting and Maximizing Your Orthopedic Revenue Cycle in 2014ReimbursementMD
 
Coding tips for busy orthopaedic practices
Coding tips for busy orthopaedic practicesCoding tips for busy orthopaedic practices
Coding tips for busy orthopaedic practicesReimbursementMD
 
2012 CPT Coding Change Part II
2012 CPT Coding Change Part II2012 CPT Coding Change Part II
2012 CPT Coding Change Part IIReimbursementMD
 
Magnetic resonance cholangiopancreatography
Magnetic resonance cholangiopancreatographyMagnetic resonance cholangiopancreatography
Magnetic resonance cholangiopancreatographyReimbursementMD
 
Ultrasound guidance for vascular access
Ultrasound guidance for vascular accessUltrasound guidance for vascular access
Ultrasound guidance for vascular accessReimbursementMD
 

More from ReimbursementMD (7)

Protecting and Maximizing Your Orthopedic Revenue Cycle in 2014
Protecting and Maximizing Your Orthopedic Revenue Cycle in 2014Protecting and Maximizing Your Orthopedic Revenue Cycle in 2014
Protecting and Maximizing Your Orthopedic Revenue Cycle in 2014
 
Coding tips for busy orthopaedic practices
Coding tips for busy orthopaedic practicesCoding tips for busy orthopaedic practices
Coding tips for busy orthopaedic practices
 
2012 CPT Coding Change Part II
2012 CPT Coding Change Part II2012 CPT Coding Change Part II
2012 CPT Coding Change Part II
 
2012 CPT Coding Changes
2012 CPT Coding Changes2012 CPT Coding Changes
2012 CPT Coding Changes
 
2012 CPT Coding Changes
2012 CPT Coding Changes2012 CPT Coding Changes
2012 CPT Coding Changes
 
Magnetic resonance cholangiopancreatography
Magnetic resonance cholangiopancreatographyMagnetic resonance cholangiopancreatography
Magnetic resonance cholangiopancreatography
 
Ultrasound guidance for vascular access
Ultrasound guidance for vascular accessUltrasound guidance for vascular access
Ultrasound guidance for vascular access
 

Recently uploaded

Role of Soap based and synthetic or syndets bar
Role of  Soap based and synthetic or syndets barRole of  Soap based and synthetic or syndets bar
Role of Soap based and synthetic or syndets barmohitRahangdale
 
CPR.nursingoutlook.pdf , Bsc nursing student
CPR.nursingoutlook.pdf , Bsc nursing studentCPR.nursingoutlook.pdf , Bsc nursing student
CPR.nursingoutlook.pdf , Bsc nursing studentsaileshpanda05
 
ORAL HYPOGLYCAEMIC AGENTS - PART 2.pptx
ORAL HYPOGLYCAEMIC AGENTS  - PART 2.pptxORAL HYPOGLYCAEMIC AGENTS  - PART 2.pptx
ORAL HYPOGLYCAEMIC AGENTS - PART 2.pptxNIKITA BHUTE
 
Male Infertility Panel Discussion by Dr Sujoy Dasgupta
Male Infertility Panel Discussion by Dr Sujoy DasguptaMale Infertility Panel Discussion by Dr Sujoy Dasgupta
Male Infertility Panel Discussion by Dr Sujoy DasguptaSujoy Dasgupta
 
Bulimia nervosa ( Eating Disorders) Mental Health Nursing.
Bulimia nervosa ( Eating Disorders) Mental Health Nursing.Bulimia nervosa ( Eating Disorders) Mental Health Nursing.
Bulimia nervosa ( Eating Disorders) Mental Health Nursing.aarjukhadka22
 
Cure of patients which terminally ill.pdf
Cure of patients which terminally ill.pdfCure of patients which terminally ill.pdf
Cure of patients which terminally ill.pdfrg0000009
 
blood bank management system project report
blood bank management system project reportblood bank management system project report
blood bank management system project reportNARMADAPETROLEUMGAS
 
"Radical excision of DIE in subferile women with deep infiltrating endometrio...
"Radical excision of DIE in subferile women with deep infiltrating endometrio..."Radical excision of DIE in subferile women with deep infiltrating endometrio...
"Radical excision of DIE in subferile women with deep infiltrating endometrio...Sujoy Dasgupta
 
ayurvedic formulations herbal drug technologyppt
ayurvedic formulations herbal drug technologypptayurvedic formulations herbal drug technologyppt
ayurvedic formulations herbal drug technologypptPradnya Wadekar
 
EXERCISE PERFORMANCE.pptx, Lung function
EXERCISE PERFORMANCE.pptx, Lung functionEXERCISE PERFORMANCE.pptx, Lung function
EXERCISE PERFORMANCE.pptx, Lung functionkrishnareddy157915
 
A presentation on Thermal gravimetry analysis (TGA)
A presentation on Thermal gravimetry analysis (TGA)A presentation on Thermal gravimetry analysis (TGA)
A presentation on Thermal gravimetry analysis (TGA)1922Jaygohel
 
AUTONOMIC NERVOUS SYSTEM organization and functions
AUTONOMIC NERVOUS SYSTEM organization and functionsAUTONOMIC NERVOUS SYSTEM organization and functions
AUTONOMIC NERVOUS SYSTEM organization and functionsMedicoseAcademics
 
Basic structure of hair and hair growth cycle.pptx
Basic structure of hair and hair growth cycle.pptxBasic structure of hair and hair growth cycle.pptx
Basic structure of hair and hair growth cycle.pptxkomalt2001
 
Employability skills, work experience presentation
Employability skills, work experience presentationEmployability skills, work experience presentation
Employability skills, work experience presentationmarwaahmad357
 
BENIGN BREAST DISEASE
BENIGN BREAST DISEASE BENIGN BREAST DISEASE
BENIGN BREAST DISEASE Mamatha Lakka
 
Understanding AIDS:a roadmap to well ess
Understanding AIDS:a roadmap to well essUnderstanding AIDS:a roadmap to well ess
Understanding AIDS:a roadmap to well essAbhishekKumar524514
 

Recently uploaded (20)

American College of physicians ACP high value care recommendations in rheumat...
American College of physicians ACP high value care recommendations in rheumat...American College of physicians ACP high value care recommendations in rheumat...
American College of physicians ACP high value care recommendations in rheumat...
 
Rheumatoid arthritis Part 1, case based approach with application of the late...
Rheumatoid arthritis Part 1, case based approach with application of the late...Rheumatoid arthritis Part 1, case based approach with application of the late...
Rheumatoid arthritis Part 1, case based approach with application of the late...
 
Role of Soap based and synthetic or syndets bar
Role of  Soap based and synthetic or syndets barRole of  Soap based and synthetic or syndets bar
Role of Soap based and synthetic or syndets bar
 
CPR.nursingoutlook.pdf , Bsc nursing student
CPR.nursingoutlook.pdf , Bsc nursing studentCPR.nursingoutlook.pdf , Bsc nursing student
CPR.nursingoutlook.pdf , Bsc nursing student
 
ORAL HYPOGLYCAEMIC AGENTS - PART 2.pptx
ORAL HYPOGLYCAEMIC AGENTS  - PART 2.pptxORAL HYPOGLYCAEMIC AGENTS  - PART 2.pptx
ORAL HYPOGLYCAEMIC AGENTS - PART 2.pptx
 
Male Infertility Panel Discussion by Dr Sujoy Dasgupta
Male Infertility Panel Discussion by Dr Sujoy DasguptaMale Infertility Panel Discussion by Dr Sujoy Dasgupta
Male Infertility Panel Discussion by Dr Sujoy Dasgupta
 
GOUT UPDATE AHMED YEHIA 2024, case based approach with application of the lat...
GOUT UPDATE AHMED YEHIA 2024, case based approach with application of the lat...GOUT UPDATE AHMED YEHIA 2024, case based approach with application of the lat...
GOUT UPDATE AHMED YEHIA 2024, case based approach with application of the lat...
 
Immune labs basics part 1 acute phase reactants ESR, CRP Ahmed Yehia Ismaeel,...
Immune labs basics part 1 acute phase reactants ESR, CRP Ahmed Yehia Ismaeel,...Immune labs basics part 1 acute phase reactants ESR, CRP Ahmed Yehia Ismaeel,...
Immune labs basics part 1 acute phase reactants ESR, CRP Ahmed Yehia Ismaeel,...
 
Bulimia nervosa ( Eating Disorders) Mental Health Nursing.
Bulimia nervosa ( Eating Disorders) Mental Health Nursing.Bulimia nervosa ( Eating Disorders) Mental Health Nursing.
Bulimia nervosa ( Eating Disorders) Mental Health Nursing.
 
Cure of patients which terminally ill.pdf
Cure of patients which terminally ill.pdfCure of patients which terminally ill.pdf
Cure of patients which terminally ill.pdf
 
blood bank management system project report
blood bank management system project reportblood bank management system project report
blood bank management system project report
 
"Radical excision of DIE in subferile women with deep infiltrating endometrio...
"Radical excision of DIE in subferile women with deep infiltrating endometrio..."Radical excision of DIE in subferile women with deep infiltrating endometrio...
"Radical excision of DIE in subferile women with deep infiltrating endometrio...
 
ayurvedic formulations herbal drug technologyppt
ayurvedic formulations herbal drug technologypptayurvedic formulations herbal drug technologyppt
ayurvedic formulations herbal drug technologyppt
 
EXERCISE PERFORMANCE.pptx, Lung function
EXERCISE PERFORMANCE.pptx, Lung functionEXERCISE PERFORMANCE.pptx, Lung function
EXERCISE PERFORMANCE.pptx, Lung function
 
A presentation on Thermal gravimetry analysis (TGA)
A presentation on Thermal gravimetry analysis (TGA)A presentation on Thermal gravimetry analysis (TGA)
A presentation on Thermal gravimetry analysis (TGA)
 
AUTONOMIC NERVOUS SYSTEM organization and functions
AUTONOMIC NERVOUS SYSTEM organization and functionsAUTONOMIC NERVOUS SYSTEM organization and functions
AUTONOMIC NERVOUS SYSTEM organization and functions
 
Basic structure of hair and hair growth cycle.pptx
Basic structure of hair and hair growth cycle.pptxBasic structure of hair and hair growth cycle.pptx
Basic structure of hair and hair growth cycle.pptx
 
Employability skills, work experience presentation
Employability skills, work experience presentationEmployability skills, work experience presentation
Employability skills, work experience presentation
 
BENIGN BREAST DISEASE
BENIGN BREAST DISEASE BENIGN BREAST DISEASE
BENIGN BREAST DISEASE
 
Understanding AIDS:a roadmap to well ess
Understanding AIDS:a roadmap to well essUnderstanding AIDS:a roadmap to well ess
Understanding AIDS:a roadmap to well ess
 

Thyroid fine needle aspiration vs. thyroid biopsy

  • 1. THYROID FINE NEEDLE ASPIRATION vs THYROID BIOPSY Quick Look: • Explain the variances between Thyroid Nodule FNA and Thyroid Biopsy • CPT code choice 10022 or 60100 • Report example of conflicting verbiage Selecting the correct CPT code choice when reviewing documentation for biopsies and FNA’s are dependent on the description provided by the physician. If the documentation supports the verbiage of a biopsy, we will code 60100. If it supports an aspiration, we will assign 10022. Often times the radiologist will use the terms FNA and biopsy interchangeably when reporting these services. Due to the different CPT code choices, conflicting documentation can make code assignment difficult for the coder. Though the basic rules apply to all biopsies and FNA’s, we typically experience the biggest problem with thyroid procedures. In an effort to improve documentation and streamline the code choice, I am supplying coding guidelines that apply to these procedures. FNA Thyroid biopsy 10022 ~ Fine needle aspiration with imaging guidance 60100 ~ Biopsy thyroid, percutaneous core needle A needle core biopsy is most often performed using a large- FNA is typically performed with a small-gauge needle gauge cutting needle FNA's are routinely sent to pathology for cytology Biopsies are sent to pathology for histology Cytology is often immediately available for interpretation Histology is processed overnight FNA can be reported once for each lesion that is aspirated Needle core biopsy codes are reported once per lesion Multiple passes with the needle into the same lesion If multiple specimens are taken from the same lesion, only is considered to be a single FNA one biopsy procedure should be reported Additional coding information: • The coder is instructed NOT to use the size of the needle to distinguish between needle core biopsy and FNA • According to CPT, the imaging guidance code should be reported once for each lesion or area • Medicare allows only one unit of service for the guidance regardless of the number of needle placements performed • Codes for both a biopsy and a needle aspiration cannot be billed together at the same session unless documentation supports inadequate specimen sampling by pathology with one technique (usually the FNA) requiring the other technique (usually the core biopsy) to obtain adequate material. • If documentation is unclear, the radiologist needs to be asked to clarify the technique in an addendum T. Galan -1- Thyroid FNA vs Biopsy HIS-South, Radiology Division February 3, 2011
  • 2. CONFLICTING REPORT EXAMPLE Ultrasound guided thyroid biopsy. History: Thyroid nodule. Comparison: None. Findings: There are two large nodules that are heterogeneous and solid in the left thyroid lobe. Physician orders state to biopsy the larger lower pole nodule in the left thyroid lobe. The risks and benefits of the procedure including, infection, bleeding, injury to surrounding structures was discussed with the patient. The patient gave informed consent. A timeout was performed to verify the site of procedure, type of procedure and patient identification. The patient was prepped and draped in a sterile manner. 1% Lidocaine was used for local anesthesia. Three samples of the lower pole large solid 2.3 cm nodule was obtained by ultrasound guidance using a 25-gauge needle. These 3 fine-needle aspirates were considered adequate by pathology at the bedside. No immediate complications. Impression: Successful fine needle aspiration of lower pole solid left thyroid lobe nodule. T. Galan -2- Thyroid FNA vs Biopsy HIS-South, Radiology Division February 3, 2011