Medicare Compliance & Reimbursement - 2012 Issue 6
Reader Question: Remember 19102 Ancillary Services
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Article Overview
This premium article explains the coding considerations for a breast biopsy case with bilateral work, fluoroscopic guidance, and placement of localization clips. It is intended for coding professionals who need to understand how ancillary services may be reported in the hospital setting and how imaging-related services are handled when more than one provider may be involved.
Why This Topic Matters
Breast biopsy encounters can include multiple separately reported services, and correct identification of the primary procedure, imaging guidance, and clip placement affects accurate claim submission and compliance.
Article Sections
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Question
Presents a breast biopsy scenario involving work on both sides and associated imaging and localization services in a hospital setting.
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Answer
Explains the general coding approach for the biopsy encounter, including the ancillary imaging component and component-based reporting considerations.
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Capture clip
Addresses the separate reporting consideration for placement of a localization clip during the biopsy encounter.
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Caution
Notes the role of a different provider when imaging guidance is furnished separately in the encounter.
What You Will Learn
- How a breast biopsy encounter with imaging guidance is discussed from a coding perspective.
- How ancillary services may be separated from the primary procedure in a hospital setting.
- How localization clip placement is treated as part of the overall scenario.
- How provider roles may affect reporting of imaging-related services.
Who Should Read This
- Medical coders
- Billing specialists
- Compliance staff
- Radiology coding professionals
- Surgical coding professionals
Codes Discussed
Modifiers Discussed
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