2025 CPT code 10005
(Active) Effective Date: N/A Revision Date: N/A Surgery - General Surgical Procedures Surgery Feed
Fine needle aspiration biopsy, including ultrasound guidance; first lesion.
Modifier 59 (Distinct Procedural Service) may be applied when multiple FNA biopsies are performed on separate lesions with different imaging modalities or when an FNA is performed in conjunction with a core needle biopsy on a separate lesion.
Medical necessity is established when imaging reveals a suspicious lesion (e.g., nodule, mass) requiring cytological evaluation to differentiate between benign and malignant conditions or guide further treatment.The decision to perform the procedure should be based on clinical judgment and supported by relevant clinical findings.
The physician is responsible for inserting the needle under ultrasound guidance, collecting the tissue sample, and sending it to the pathology lab for analysis.This requires expertise in image interpretation and fine needle technique.
In simple words: This code describes a procedure where a doctor uses ultrasound to guide a very thin needle to take a small sample from a suspicious lump or area. This sample is sent to a lab to check for diseases.
This CPT code encompasses a fine needle aspiration (FNA) biopsy of the first lesion, guided by ultrasound imaging.The procedure involves inserting a thin needle into a suspicious lesion to collect a tissue sample for cytological examination.Ultrasound guidance ensures accurate needle placement. The collected specimen is sent to a pathology lab for analysis.
Example 1: A patient presents with a palpable breast mass.An ultrasound-guided FNA biopsy is performed using code 10005 to obtain a sample for cytological evaluation to determine if the mass is benign or malignant., A patient has a suspicious thyroid nodule detected on ultrasound. The physician performs an ultrasound-guided FNA biopsy (10005) to evaluate for thyroid cancer.The patient has multiple nodules, so additional codes are added., A patient has a suspicious lung lesion identified on CT scan. An FNA biopsy is performed under CT guidance. Appropriate codes including imaging codes and modifier 59, if needed, are used.
* Pre-procedure imaging (ultrasound, CT, MRI, as applicable).* Detailed description of the lesion location, size, and characteristics.* Number of passes of the needle and the amount of tissue obtained.* Pathology report with cytological findings.* Documentation of the type of imaging guidance used.
** The use of this code may vary depending on the specific clinical context and the payer's guidelines. Always refer to the latest CPT manual and local coverage determination (LCD) for accurate coding and billing.
- Revenue Code: P6C (MINOR PROCEDURES - OTHER)
- Payment Status: Active
- Modifier TC rule: Not applicable. This code is for the professional component only.
- Specialties:* Radiology (interventional)* Surgery (general, thoracic, breast, etc.)* Oncology* Pathology
- Place of Service:Office, Outpatient Hospital, Ambulatory Surgical Center