Question:

When performing bilateral breast cyst aspirations, do we use 19000 and 19001 or 19000 x 2?

Answer:

That’s normally decided by the payer preference, but from as far back as the early 1990s, if two cysts in the same breast were aspirated, then you would report 19000 and 19001, but if one cyst in each breast was aspirated, then you would report 19000-50. Because AMA is increasingly changing the rules about “each additional” code to mean the same side or opposite side, many payers are changing this rule for everything. AMA has not specifically said that about 19000, 19001, so, it’s up in the air. Medicare has an MUE of 2 for 19000 “due to anatomic consideration” – leading us to believe that for Medicare at least, you would still code 19001 only if you have two cysts in the same breast.

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