Ask Dr. Z

What is the appropriate way to code the following? Breast or lymph node biopsy?

"36-year-old with biopsy proven right breast upper outer quadrant malig presents for US-guided biopsy of enlarged lymph node ant to malig, as seen on MRI, and for axillary tail lymph node as requested by referring physician. Informed consent was signed. After sterile prep and 1% lido the lymph node in the outer right breast 9:00 pos was initially localized for biopsy. Four passes were made through the lymph node. All samples sent to path for analysis. Hanger shaped clip was deployed. Subsequently right axillary tail lymph node was localized for biopsy. AGAIN using sterile tech and 1% lido a 16 gauge Bard needle was utilized for biopsy. Two passes were made through the lymph node. Samples sent to path for analysis. Twirl shaped clip was deployed. Successful US-guided biopsy of lymph node outer right breast @ 9:00 pos and also right axillary tail lymph node, both negative for atypia/malignancy."