Ask Dr. Z

For the following example, would you charge as a lymph node biopsy or breast biopsy? If lymph node biopsy, is it appropriate to charge for post procedure mammogram?

"52 year-old with newly diagnosed right breast malignancy and prominent right axillary lymph node. The procedure and risks of ultrasound-guided core biopsy and ultrasound-guided metallic localizer clip placement for a right axillary lymph node were discussed in full with the patient. Both oral and written consents were obtained. With ultrasound guidance, aseptic technique, and 1% lidocaine and lidocaine with epinephrine as the local anesthetic, the mass of concern was sampled 3 times with a 14 gauge Achieve biopsy needle. Immediately thereafter, a metallic localizer clip was placed within the mass. Direct pressure was applied to the site immediately post procedure, and hemostasis was achieved. The site was bandaged with antibiotic ointment. POST PROCEDURE MAMMOGRAM was performed in a separate room: The localizer clip is in the expected location of the axillary lymph node."