Will there ever be a situation where we
assign a biopsy code and a localization
code for the same lesion?
No. Since the biopsy codes by definition
include placement of a localization
device it would not be appropriate to
assign two comprehensive codes for
addressing one lesion. If separate and
distinct lesions are addressed (eg, one is
biopsied and the other has a localization
device placed) then it would be appropriate to separately code these procedures. Appropriate modifiers would
need to be appended to comply with
What about fine needle aspiration (FNA)
The new codes do not include FNA biopsies so these procedures should be coded as
FNA (10022) plus either ultrasound or
MR. Note that there are no cross-references
in the CPT Manual that allow for stereotactic or mammographic FNA procedures.
Four new percutaneous drainage proce-
From a coding perspective, what is the
dure codes have been created to address
percutaneous drainage of fluid collec-
tions, which may include not only
abscesses but also hematomas, seromas,
lymphoceles, and cysts. Code 10030 will
be used for soft tissue drainage while the
other three codes are defined for specific
areas. See Table 2.
difference between drainage and
Drainage codes are assigned when the
physician leaves a catheter in place at the
end of the procedure for continued
drainage of fluid. Code assignment is not
based on how the procedure is performed, but rather whether or not the
patient has a catheter left in place when
they leave the suite.
What is included in the new codes?
The codes include the surgical procedure
as well as all imaging guidance utilized to
perform the procedure.
If we utilize two different imaging
modalities can we assign two drainage
No. The codes include all imaging to perform the procedure regardless of the
amount and type(s) of imaging required
to accomplish the procedure.
Are there any circumstances where we
would assign multiple codes?
Yes. If there are separate and distinct fluid
What code should we assign for
collections and separate catheters are uti-
lized for each collection then you are
allowed to code for each distinct proce-
dure. Modifiers would need to be applied
according to the individual payor guide-
percutaneous drainage of a fluid
collection in the psoas muscle?
Per “Clinical Examples in Radiology Fall
2013,” code 49406 should be reported for
Embolization of Non-Neuro,
Four new embolization codes have been
added for 2014 that include the radiological supervision and interpretation. They
are defined in terms of the type of lesion
that is being embolized. Remember that
the neuro and non-neuro head and neck
codes 61624 and 61626 still exist and
should be assigned when those procedures are performed. The full code definitions are listed in Table 3 with examples
of how these codes might be used.
What is included in the new embolization
The new codes include all of the imaging
to perform the procedure, including
roadmapping, and any completion angiograms so it would not be appropriate to
assign code 75894 (embolization RS&I)
and/or 75898 (follow-up angiography)
with the new codes.
TABLE 2. New Codes: Percutaneous Drainage
CPT® Code Definition
10030 Image-guided fluid collection drainage by catheter (eg, abscess, hematoma, seroma,
lymphocele, cyst), soft tissue (eg, extremity, abdominal wall, neck), percutaneous
49405 Image-guided fluid collection drainage by catheter (eg, abscess, hematoma, seroma,
lymphocele, cyst); visceral (eg, kidney, liver, spleen, lung/mediastinum), percutaneous
49406 . . . peritoneal or retroperitoneal, percutaneous
49407 . . . peritoneal or retroperitoneal, transvaginal or transrectal