Hello,

I'll answer each of your questions separately.

>At our hospital we issue a technical bill (hospital charge) and professional 
>bill (pathologists separate billing charge) for each surgical and cytology 
>procedure.   

>What CPT code do you use to bill a hospital charge for FNA performed without 
>radiological guidance, 

88170.TC (technical component)
The professional component (88170.26) would be billed by whomever performs 
the aspiration procedure.

>and which CPT code do you use to bill a hospital charge for FNA performed 
with >radiological guidance?

88171.TC (technical component)
The radiologist would usually pick up the professional component (88171.26)

>There are three choices (88170, 88172, and 88173) in the 2000 CPT codebook, 
>therefore, it is confusing.

There are actually two choices for the performance of the aspiration (88170, 
88171), one choice for the determination of adequacy (88172) and one choice 
for the interpretation and report (88173).

Keep in mind that cell blocks (88305), core biopsies (88305 or 88307 
depending on source) and special stains (88312, 88313 and 88342) are billed 
as well when performed.

When direct smears (touch preps) on cores are performed for adequacy the 
codes would be 88161 and 88329.  Frozen sections performed on core biopsies 
would be coded 88331.

>Also, do you issue an additional hospital charge for "FNA adequacy" when 
clinician >wants slides reviewed for adequacy before proceeding with the FNA 
procedure?

Yes, 88172.TC for the technical component and
88172.26 (professional component) billed by the pathologist.

>For the above procedures, which CPT codes do you use for the pathologists 
>professional billing charges?  

The above codes with modifier -26 with the exception of 88171 (radiologic 
guidance) which is not normally performed by a pathologist.

These codes are per each aspirate requiring separate 
evaluation/interpretation.

>Thank you in advance for your input.

I hope I haven't left anything out.  Let me know if you require further 
clarification.

Matt Bowers
Lab Manager
Visalia Path Med Grp
Visalia, CA