fine needle aspirations in the office

Our new surgeon is performing fine needle aspirations in the office and wants to bill for the use of the ultrasound machine. The practice owns the machine.  Is this a separately reportable service, and if yes, how do we report this?

Answer:

Yes, the service is separately reportable. The key to reporting lies in your statement that you own the equipment as this allows the practice to report the “global” radiology code.

Let’s take a look at CPT® code 76942, Ultrasonic guidance for needle placement (eg, biopsy, aspiration, injection, localization device), imaging supervision and interpretation.  CPT®code 76942 without any modifiers appended is considered a global radiology code. Medicare will consider payment for radiology codes if the service is reported as a global code (without modifiers), or if the service is reported with a professional component modifier 26 for the professional interpretation, or if there is a TC modifier indicating the technical component only.

In the grid that follows, you see that payment for the global code is 5.04 RVUs.  Medicare pays the global code when the physician performs the service in the office setting and provides the professional interpretation.  In your scenario, the global payment would apply because the office owns the technology and the physician is using the technology to perform the aspiration.