Wednesday, October 5, 2011

CPT 10021, 10022, 19000 - 17340 for assistant surgeon

Procedure code and Description

10021 Fine Needle Aspiration (FNA) without imaging guidance

10022 Fine Needle Aspiration (FNA) with imaging guidance


19000 Puncture aspiration breast cyst

Mississippi Medicaid Global Days Assignment

Effective: 1/1/2015
Print Date: 3/3/2015
GLOBAL DAY

Procedure Code Global Days Assignment

1000F 999
10021 999

10022 999

Correspondence Language Policy/Example Number 5.10000 - Sequential procedure For example, CPT code 10021 describes a fine needle aspiration biopsy without imaging guidance. CPT code 19101 describes an open incisional biopsy of the breast. If a fine needle aspiration biopsy of a breast lesion is unsuccessful and the physician sequentially performs an incisional biopsy of the same lesion at the same patient encounter, only the successful open incisional biopsy may be reported. Therefore, CPT code 10021 is not separately reportable with CPT code 19101.

Correspondence Language Policy/Example Number 5.60000 - Sequential procedure

For example, if a fine needle aspiration of the thyroid (CPT code 10021) is unsuccessful and is followed at the same patient encounter by a percutaneous core needle biopsy of the thyroid (CPT code 60100), only CPT code 60100 may be reported. Therefore, CPT code 10021 is not separately reportable with CPT code 60100.



The unit of service for fine needle aspiration (CPT codes 10021 and 10022) is the separately identifiable lesion. If a physician performs multiple “passes” into the same lesion to obtain multiple specimens, only one unit of service may be reported. However, a separate unit of service may be reported for separate aspiration(s) of a distinct separately identifiable lesion.


Fine needle aspiration (FNA) (CPT codes 10021, 10022) should not be reported with another biopsy procedure code for the same lesion unless one specimen is inadequate for diagnosis. For example, an FNA specimen is usually examined for adequacy when the specimen is aspirated. If the specimen is adequate for diagnosis, it is not necessary to obtain an additional biopsy specimen. However, if the specimen is not adequate and another type of biopsy (e.g., needle, open) is subsequently performed at the same patient encounter, the other biopsy procedure code may also be reported with an NCCI-associated modifier.


10000 series procedure codes that are "Nevers" for Assistant Surgeon

The below table identified procedure codes that are not eligible for reimbursement when reported by an Assistant Surgeon.

10021 11311 11643 12007 14020 15261 15789 16000 19001
10022 11312 11644 12011 14021 15300 15792 16020 19020
10040 11313 11646 12013 14040 15301 15793 16025 19030
10060 11400 11719 12014 14041 15320 15819 16030 19100
10061 11401 11720 12015 14060 15321 15820 16035 19101
10080 11402 11721 12016 14061 15330 15821 16036 19102
10081 11403 11730 12017 14350 15331 15822 17000 19103
10120 11404 11732 12020 15002 15335 15823 17003 19105
10121 11406 11740 12021 15003 15336 15824 17004 19110
10140 11420 11750 12031 15004 15340 15825 17106 19112
10160 11421 11752 12032 15005 15341 15826 17107 19120
10180 11422 11755 12034 15040 15360 15828 17108 19125
11000 11423 11760 12035 15050 15361 15829 17110 19126
11001 11424 11762 12036 15100 15365 15833 17111 19290
11004 11426 11765 12037 15101 15366 15834 17250 19291
11005 11307 11640 12004 13160 15240 15786 15950 17360
11006 11308 11641 12005 14000 15241 15787 15951 17380
11008 11310 11642 12006 14001 15260 15788 15953 19000
11010 11440 11770 12041 15110 15400 15835 17260 19295
11011 11441 11771 12042 15111 15401 15836 17261 19296
11012 11442 11772 12044 15115 15420 15837 17262 19297
11040 11443 11900 12045 15116 15421 15838 17263 19298
11041 11444 11901 12046 15120 15430 15839 17264 19300
11042 11446 11920 12051 15121 15431 15850 17266 19301
11043 11450 11921 12052 15130 15570 15851 17270 19324
11044 11451 11922 12053 15131 15572 15852 17271 19325
11045 11462 11950 12054 15135 15574 15860 17272 19328
11046 11463 11951 12055 15136 15576 15876 17273 19330
11047 11470 11952 12056 15150 15600 15877 17274 19340
11055 11471 11954 13100 15151 15610 15878 17276 19342
11056 11600 11960 13101 15152 15620 15879 17280 19350
11057 11601 11970 13102 15155 15630 15920 17281 19355
11100 11602 11971 13120 15156 15650 15931 17282 19370
11101 11603 11975 13121 15157 15736 15933 17283 19371
11200 11604 11976 13122 15170 15740 15934 17284 19380
11201 11606 11977 13131 15171 15760 15936 17286 19396
11300 11620 11980 13132 15175 15775 15937 17311
11301 11621 11981 13133 15176 15776 15940 17312
11302 11622 11982 13150 15200 15780 15941 17313
11303 11623 11983 13151 15201 15781 15944 17314
11305 11624 12001 13152 15220 15782 15945 17315
11306 11626 12002 13153 15221 15783 15946 17340

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