How To Use cpt 10035

cpt 10035 describes the placement of a soft tissue localization device(s) into the patient’s body using a percutaneous approach. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples of cpt 10035.

1. What is cpt 10035?

cpt 10035 is a code used to describe the placement of soft tissue localization device(s) into the patient’s body. These devices, such as clips, metallic pellets, wires/needles, or radioactive seeds, are inserted through a needle that is guided by imaging techniques. The purpose of this procedure is to mark the exact location of suspicious tissue for a subsequent surgical procedure or radiation treatment.

2. Official Description

The official description of cpt 10035 is: ‘Placement of soft tissue localization device(s) (eg, clip, metallic pellet, wire/needle, radioactive seeds), percutaneous, including imaging guidance first lesion.’

3. Procedure

The procedure for cpt 10035 involves the following steps:

1. The patient is appropriately prepped and anesthetized.
2. The healthcare provider uses imaging guidance, such as fluoroscopy or ultrasound, to view the exact location of the lesion in the affected soft tissue.
3. A needle introducer is used to place the localization device through the skin to the target tissue.
4. After placing the device, the healthcare provider uses imaging guidance to ensure the correct position of the device.
5. The site is closed, and a bandage is applied.

4. Qualifying circumstances

cpt 10035 is used when a soft tissue localization device is placed into the patient’s body for the purpose of marking suspicious tissue. This procedure is typically performed when there is a need for a subsequent surgical procedure or radiation treatment. It is important to note that if a more specific site descriptor than soft tissue is applicable, such as breast, the site-specific codes for marker placement at that site should be used.

5. When to use cpt code 10035

cpt 10035 should be used when the healthcare provider performs the initial placement of a soft tissue localization device for the first lesion. If additional devices are placed, the +10036 code should be used in addition to the primary procedure code. It is important to use the appropriate code based on the number of devices placed and to consider the primary procedure being performed.

6. Documentation requirements

To support a claim for cpt 10035, the healthcare provider must document the following information:

• Patient’s diagnosis and the need for soft tissue localization
• Specific type of device used (clip, metallic pellet, wire/needle, radioactive seeds)
• Date of the procedure
• Imaging guidance used (fluoroscopy, ultrasound, or other forms of imaging)
• Number of devices placed
• Location of the placement (if applicable)
• Any additional procedures performed in conjunction with the placement of the device
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for cpt 10035, it is important to ensure that the procedure is performed percutaneously and includes imaging guidance for the first lesion. If additional devices are placed, the +10036 code should be used in addition to the primary procedure code. It is also important to consider the primary procedure being performed and to use the appropriate code based on the number of devices placed. Soft tissue-marker placement with imaging guidance should only be reported once per target, regardless of how many markers are used.

8. Historical information

cpt 10035 was added to the Current Procedural Terminology system on January 1, 2016. There have been no updates to the code since its addition.

9. Similar codes to cpt 10035

Five similar codes to cpt 10035 include:

• cpt 10036: This code is used for each additional soft tissue localization device placed after the initial placement.
• cpt 10021: This code is used for fine needle aspiration biopsy without imaging guidance.
• cpt 10022: This code is used for fine needle aspiration biopsy with imaging guidance.
• cpt 10030: This code is used for image-guided fluid collection drainage by catheter (eg, abscess, hematoma, seroma, lymphocele, cyst).
• cpt 10060: This code is used for incision and drainage of abscess (eg, carbuncle, suppurative hidradenitis, cutaneous or subcutaneous abscess, cyst, furuncle, or paronychia).

9. Examples

1. A radiologist placing a metallic pellet into the breast tissue to mark a suspicious lesion for subsequent surgical removal.
2. An oncologist inserting radioactive seeds into the prostate gland to mark the location of cancerous cells for radiation treatment.
3. A surgeon placing a clip into the lung tissue to mark the location of a nodule for a future thoracoscopic resection.
4. An interventional radiologist inserting a wire/needle into the liver to mark the location of a tumor for subsequent ablation therapy.
5. A gynecologist placing a clip into the cervix to mark the location of abnormal cells for a future cone biopsy.
6. A urologist inserting radioactive seeds into the prostate gland to mark the location of cancerous cells for brachytherapy.
7. A dermatologist placing a metallic pellet into the skin to mark the location of a suspicious mole for subsequent excision.
8. An orthopedic surgeon inserting a wire/needle into the bone to mark the location of a fracture for subsequent surgical repair.
9. A neurosurgeon placing a clip into the brain tissue to mark the location of a tumor for subsequent resection.
10. An interventional radiologist inserting a wire/needle into the kidney to mark the location of a stone for subsequent lithotripsy.