Is your lab following new FNA coding guidelines?

February 27, 2019

In case you missed it when these changes were first signaled last fall, CPT coding for fine needle aspiration (FNA) has been significantly overhauled as of Jan. 1, 2019.

For starters, labs must now avoid reporting FNA separately with imaging guidance. Now, a single CPT code, 10021, covers fine needle aspiration of an initial lesion, without imaging guidance, and four new codes have been added to report fine needle aspiration of an initial lesion using specified imaging modalities (ultrasound, fluoroscopy, CT or MR).

Despite the new restriction on being able to report imaging separately with these codes, providers may combine primary and add-on codes in any combination to report necessary services.

However, keep in mind that pathologists may report only one initial lesion code before they must add a 59 modifier to any additional lesion codes reported if the add-on and the initial code describe different types of imaging.

Those not adhering to these guidelines have already seen their ability to get paid for these procedures impacted. If your lab or group is seeking additional guidance concerning the exact changes, feel free to reach out to our team directly at 517-486-4262.

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Are you billing all the correct CPT codes? You’d be surprised at what you might be missing. We will review your Fee Schedule/Charge Master at no cost.

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