September 17, 2020

Question:
We did an abdominal fat pad biopsy for primary cutaneous Amyloidosis. Would 49180 or 11104 be the appropriate code for this?

Answer:
49180 is for a core sample within or behind the abdominal cavity. If the core biopsy is documented down to the subcutaneous fat pad only, this is coded as a punch biopsy 11104. And if the provider documents ultrasound guidance with proper documentation (i.e., noting anatomical findings and needle placement), 76942 can be billed as well with modifier 26 if indicated.

*This response is based on the best information available as of 9/17/20.