Question:

If a percutaneous thyroid biopsy is ordered and we perform a thyroid ultrasound prior to the biopsy to localize the nodule to be biopsied, may we code 76536 in addition to 60100 and 76942?

Answer:

No, the localization ultrasound is considered part of the guidance for the biopsy and is included in 76942. If a diagnostic thyroid ultrasound is ordered, and based on findings the decision is made to proceed to an ultrasound-guided biopsy (and that decision is documented), then it would be appropriate to code the following:

76536 Ultrasound, soft tissues of head and neck (e.g., thyroid, parathyroid, parotid), real time with image documentation
60100 Biopsy thyroid, percutaneous core needle
76942-59 Ultrasonic guidance for needle placement (e.g., biopsy, aspiration, injection, localization device), imaging supervision and interpretation

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