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62267 versus 20225

Date: Nov 1, 2021

Question:

We have different opinion with this scenario. Not sure if this is coded endplate biopsy with 20225, or since aspiration also performed 62267. Please advise. 

"Per H/P recent MRI showed evidence of L5-S1 discitis.

Procedure: The L5-S1 disc level was markedly narrowed. No window could be identified for access.

As marrow edema was seen to extend to the superior endplate of L5 on recent MRI, biopsy was performed at this level 4 samples were obtained at the superior endplate of L5 utilizing a 13-gauge 15 cm Murphy needle utilizing 1% buffered lidocaine for local anesthesia. 22-gauge aspirates were obtained with a Chiba needle through the outer cannula of the Murphy needle as well.

Impression: Uncomplicated CT-guided biopsy superior endplate of L5. No adequate window identified to approach the L5-S1 level as described above

Pathology: Bone, vertebral L5-S1, CT-guided biopsy

- Degenerative cartilaginous change consistent with osteoarthritis

Polarizable calcium pyrophosphate crystalline deposits consistent with pseudogout."

Question ID : 16152
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