Ask Dr. Z

Since combining image guidance with interventional procedures into a single code has become a trend, is the US guidance documentation such as "permanent image recorded" required for both the combination code and the individual image guidance code? For example: Breast biopsy under US guidance (19083) vs. puncture aspiration of cyst of breast under US guidance (19000, 76942). Or, because US guidance is built into 19083, it isn’t required to state "permanent image recorded", whereas in contrast 76942 is an individual code and it is required to state "permanent image recorded"? Please help.