A 55-year-old patient with suspected liver cancer was seen by the physician to obtain a biopsy. The special biopsy needle was placed using ultrasonic guidance. The physician obtained a small tissue sample from the liver, which was then sent to pathology. What CPT® codes are reported?

The procedure described is a percutaneous needle biopsy of the liver, which is correctly reported with CPT® code 47000. The physician used ultrasonic guidance to place the needle, which is a separate, reportable service. CPT® code 76942 is used for ultrasonic guidance for needle placement. The -26 modifier (Professional Component) is appended to 76942 to indicate that the physician provided only the supervision and interpretation for the guidance, and does not own the equipment, which is typical in a facility setting.

A. This is incorrect because CPT® code 77002 describes fluoroscopic guidance, not the ultrasonic guidance that was used in the procedure.
B. This is incorrect because CPT® code 10005 is for a fine needle aspiration (FNA) that includes ultrasound guidance; the scenario describes a tissue sample biopsy, not an FNA.
C. This is incorrect because CPT® code 47100 is for an open wedge biopsy of the liver, not a percutaneous needle biopsy, and 77012 is for CT guidance.

1. American Medical Association. (2023). CPT® 2024 Professional Edition.

Code 47000: Under the "Liver" subsection of the "Digestive System

" this code is defined as "Biopsy of liver

needle; percutaneous." (p. 389).

Code 76942: In the "Radiology" section

under "Diagnostic Ultrasound

" this code is defined as "Ultrasonic guidance for needle placement (eg

biopsy

aspiration

injection

localization device)

imaging supervision and interpretation." (p. 581).

Appendix A - Modifiers: Modifier 26 is defined as "Professional Component." (p. 869).

2. AAPC. (2023). 2024 CPC Official Certification Study Guide. Chapter 11: Digestive System.

The section on the liver explains that CPT® 47000 is the appropriate code for a percutaneous needle biopsy. It also clarifies that any imaging guidance used during the procedure should be coded separately from the appropriate radiology section.

3. AAPC. (2023). 2024 CPC Official Certification Study Guide. Chapter 14: Radiology.

This chapter details the use of imaging guidance codes. It specifies that 76942 is the correct code for ultrasonic guidance for needle placement and that it is reported in addition to the primary procedure code (e.g.

47000). It also explains the application of modifier 26 for the professional component.