Sherry Posted Tue 19th of December, 2017 09:28:30 AM
The physician performed an EUS, he performed an FNA on 5 abnormal lymph nodes, but he also did what seems like drainage but also biopsy on a pleural effusion. Here is how he words it:
"A moderate-sized pleural effusion was present. This fluid was visualized
endosonographically as an anechoic structure. It was triangular. The
pleural effusion contained no thick septations. There was floating
debris present within the pleural effusion. Diagnostic and therapeutic
needle aspiration for fluid was performed. Color Doppler imaging was
utilized prior to needle puncture to confirm a lack of significant
vascular structures within the needle path. One pass was made with the
19 gauge needle using a transesophageal approach. A stylet was used. The
amount of fluid collected was 20 mL. The fluid was turbid, yellow and
watery. Sample(s) were sent for cytology."
Should we only bill the FNA or should we bill the FNA and an unspecified code for the fluid that was aspirated. I know for the most part it probably should just be FNA since it was collected and sent for cytology, I just want to confirm because of how it was all worded, just to be 100% I don't miss anything.
SuperCoder Answered Wed 20th of December, 2017 06:47:43 AM
For endoscopy procedures that include EUS with biopsy or FNA specimen extraction, one can choose one of the following three codes :
- 43232 -- Esophagoscopy, rigid or flexible; with transendoscopic ultrasound-guided intramural or transmural fine needle aspiration/biopsy(s)
- 43238 -- Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; with transendoscopic ultrasound- guided intramural or transmural fine needle aspiration/biopsy(s), esophagus (includes endoscopic ultrasound examination limited to the esophagus)
- 43242 -- ... with transendoscopic ultrasound-guided intramural or transmural fine needle aspiration/biopsy(s) (includes endoscopic ultrasound examination of the esophagus, stomach, and either the duodenum and/or jejunum as appropriate).
Hope this helps!