CPT® Code 10008

Add-On Code

Fine needle aspiration biopsy, including fluoroscopic guidance; each additional lesion (List separately in addition to code for primary procedure)

The CPT® Code 10008 refers to a fine needle aspiration biopsy (FNA) that includes fluoroscopic guidance for each additional lesion. This procedure utilizes a fine gauge needle, typically 22- or 25-gauge, along with a syringe to extract fluid from cysts or to collect clusters of cells from solid masses. The process begins with the cleansing of the biopsy site, followed by the physician locating the lump through palpation. In cases where the lump is not palpable, imaging guidance, such as fluoroscopy, is employed to assist in accurately targeting the lesion for biopsy. For lesions that are more easily localized, fluoroscopic or ultrasound guidance may be utilized to enhance precision during the procedure. Once the needle is inserted into the mass, a vacuum is created, and the physician performs multiple in-and-out motions with the needle while pulling back on the syringe to ensure an adequate tissue sample is obtained. It is common for several needle insertions to be necessary to collect sufficient material for analysis. The collected samples are then prepared by smearing them onto a microscope slide, allowing them to air dry, and subsequently fixing them through spraying or immersion in a liquid. After fixation, the smears are stained and examined under a microscope by a pathologist for diagnostic purposes. Notably, FNA biopsies do not require stitches and are typically performed on an outpatient basis, allowing many patients to resume their normal activities on the same day. After the procedure, a small bandage is applied to the biopsy site. For billing purposes, code 10005 is used for the first lesion biopsied by FNA with ultrasound guidance, code 10006 is designated for each additional lesion biopsied under ultrasound guidance, code 10007 is for the first lesion biopsied with fluoroscopic guidance, and code 10008 is specifically for each additional lesion biopsied with fluoroscopic guidance.