Medicare Compliance & Reimbursement - 2014 Issue 12
Reader Question: Focus Breast Biopsy Codes
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Article Overview
This article addresses a reader question about breast biopsy coding in CPT and explains the current framework for reporting percutaneous breast lesion biopsy services. It is intended for coders, billers, and practice staff who need to understand how breast biopsy reporting is organized, why older code-selection approaches no longer apply, and how the topic relates to changes in CPT code reporting over time.
Why This Topic Matters
Breast biopsy coding changed materially over time, so accurate reporting depends on recognizing the current CPT structure and avoiding outdated code selection habits. The article is useful for teams that code breast procedures and need to stay aligned with current CPT updates.
Article Sections
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Question
Introduces the coding question that the article addresses and frames the topic around breast biopsy reporting in CPT.
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Answer
Summarizes the current approach to breast biopsy coding and notes that the relevant coding framework is based on imaging modality and lesion count rather than the older sampling-method distinction.
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Change codes for additional lesions
Covers reporting considerations when more than one lesion is biopsied in a single session and identifies the existence of add-on reporting for subsequent lesions.
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Old way
Explains the historical context for breast biopsy coding and references the prior CPT structure that was later deleted.
What You Will Learn
- How the article frames current CPT breast biopsy reporting
- How breast biopsy code selection is organized at a high level
- How additional lesion reporting is addressed in CPT
- Why older breast biopsy coding concepts are no longer current
Who Should Read This
- Medical coders
- Medical billers
- Physician office staff
- Outpatient surgery coding staff
Codes Discussed
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