New FNA Codes and Diagnostic Ultrasound

Question:

I understand that the new FNA with ultrasound code, 10005, includes the ultrasound guidance for the FNA.  But, can we also charge 76536?

Answer:

Yes, if you have performed a separate diagnostic ultrasound to support 76536.  Remember, this is a radiology code. So if you are reporting 76536 without any modifiers (modifier 26-professional component or modifier TC for technical component) then you are billing for the diagnostic ultrasound interpretation like a radiologist would. Therefore, there must be a separate radiologic supervision and interpretation note for the diagnostic ultrasound.  This note would stay with the diagnostic study and be provided with the diagnostic study images if ever requested by the patient or someone else.

*This response is based on the best information available as of 09/05/19.

 
 
KZA - Otolaryngology (ENT) - Coding Coach
 
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