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Question:
What if there is a cyst in each breast? How is this coded?
Answer:
Providers should check for payer-specific guidelines. Traditionally this would have been coded 19000-50 or 19000-RT and 19000-LT. However, due to a bilateral indicator of 0 in the Medicare Physician Fee Schedule, for Medicare patients, aspiration of cysts in each breast would be coded 19000 x 2. It has an MUE of 2 (MAI – 3; Date of Service Edit: Clinical). Some payers may require 19000 and 19001 even when the cysts are in separate breasts.
This question was answered in our Breast & Bone Density Procedure Coding Guide. For more hot topics relating to radiology services, please visit our store or call us at 1.800.252.1578, ext. 2.
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