2025 CPT code 32408
(Active) Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on the Respiratory System Surgery Feed
Core needle biopsy of lung or mediastinum, percutaneous, with imaging guidance.
Modifiers 59 (distinct procedural service) and 52 (reduced services) are applicable depending on the clinical scenario.See long description for details.
Medical necessity for a core needle lung or mediastinal biopsy is established based on clinical findings suggesting a possible malignancy or other serious condition, often determined by imaging studies that show a suspicious lesion needing histopathological evaluation for diagnosis and treatment planning.
The physician's responsibility includes patient preparation, anesthesia administration (if applicable), making the incision, obtaining tissue samples using imaging guidance (ultrasound, fluoroscopy, CT, MRI), hemostasis, and post-procedure care.
In simple words: This procedure involves taking a small sample of tissue from a lung or the area between the lungs (mediastinum) using a needle.This is often guided by imaging like ultrasound or CT scans. The sample is then tested to help diagnose conditions such as cancer.
This CPT code encompasses the percutaneous core needle biopsy of a lung or mediastinal lesion, inclusive of image guidance (ultrasound, fluoroscopy, CT, or MRI) when performed.The procedure involves obtaining a core tissue sample for histopathologic evaluation.The code includes all imaging guidance, regardless of the number of modalities used for the same lesion in a single session.It is reported once per lesion sampled per session.Multiple biopsies on separate lesions in the same session require reporting 32408 once per lesion, with modifier 59 appended to subsequent biopsies.When combined with other core biopsies on different sites, modifier 59 may apply.Modifier 52 is used when an FNA biopsy is also performed on the same lesion using the same imaging guidance.If different guidance methods are used, both image-guided biopsy codes are reported with modifier 59 on one of them.In cases of FNA biopsy on one lesion and core biopsy on a separate lesion, both codes may be reported separately with modifier 59 on one code, regardless of the imaging method used.
Example 1: A 60-year-old male presents with a suspicious lung nodule detected on a low-dose CT scan. A percutaneous core needle biopsy with CT guidance is performed to obtain tissue for pathology evaluation., A 45-year-old female with a mediastinal mass identified on MRI undergoes a percutaneous core needle biopsy guided by MRI. The sample is sent for histological examination to determine if the mass is malignant or benign., A 72-year-old patient with multiple lung nodules detected during a routine chest x-ray.Multiple core needle biopsies, guided by fluoroscopy, are performed on each nodule. Code 32408 is reported once per nodule, with modifier 59 added to the subsequent biopsies.
* Detailed history and physical examination findings.* Imaging reports (CT, MRI, ultrasound, or fluoroscopy) demonstrating the lesion.* Pathology report with detailed description of the tissue sample.* Documentation of the procedure performed, including needle type and number of passes.* Anesthesia record (if applicable).* Indication for the biopsy.
** Always refer to the most current CPT and NCCI coding guidelines for accurate billing.The use of imaging guidance is implicit in the code but should be documented.
- Revenue Code: P6C (Medicare Fee Schedule: Minor Procedures - Other)
- RVU: This information is not available in provided sources.Consult the CMS Physician Fee Schedule for current RVU values and reimbursement rates.
- Payment Status: Active
- Modifier TC rule: Not applicable.
- Fee Schedule: This information is not available in the provided source.Refer to historical CMS fee schedules for past reimbursement rates.
- Specialties:Pulmonology, Thoracic Surgery, Oncology, Radiology
- Place of Service:Office, Outpatient Hospital, Ambulatory Surgical Center