How To Use cpt 10036

cpt 10036 describes the placement of soft tissue localization device(s) using percutaneous techniques. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples of cpt 10036.

1. What is cpt 10036?

cpt 10036 is a code used to describe the placement of soft tissue localization device(s) using percutaneous techniques. This procedure involves the insertion of a tiny metallic or radioactive device into the patient’s body through a needle, in order to mark the exact location of suspicious tissue for a subsequent surgical procedure or radiation treatment. The provider uses imaging guidance, such as fluoroscopy or ultrasound, to ensure accurate placement of the device.

2. Official Description

The official description of cpt 10036 is: ‘Placement of soft tissue localization device(s) (eg, clip, metallic pellet, wire/needle, radioactive seeds), percutaneous, including imaging guidance each additional lesion (List separately in addition to code for primary procedure)’

3. Procedure

1. The provider assesses the patient’s condition and determines the need for soft tissue localization.
2. Using imaging guidance, such as fluoroscopy or ultrasound, the provider identifies the exact location of the suspicious tissue.
3. A needle is inserted through the patient’s skin and guided to the target tissue.
4. The provider places a tiny metallic or radioactive device through the needle into the target tissue to mark its location.
5. The provider verifies the correct position of the device using imaging guidance.
6. The site is closed and a bandage is applied.

4. Qualifying circumstances

cpt 10036 is typically performed when there is a need to mark the exact location of suspicious tissue for a subsequent surgical procedure or radiation treatment. The procedure is performed using percutaneous techniques, which involve inserting a needle through the patient’s skin. The provider uses imaging guidance, such as fluoroscopy or ultrasound, to ensure accurate placement of the device. It is important to note that cpt 10036 should not be reported in conjunction with codes 76942, 77002, or 77012.

5. When to use cpt code 10036

cpt 10036 should be used when a provider performs the placement of soft tissue localization device(s) using percutaneous techniques. This code should be reported for each additional lesion, in addition to the primary procedure code. It is important to ensure that the appropriate primary code, cpt 10035, is reported along with cpt 10036 to receive reimbursement from payers.

6. Documentation requirements

To support a claim for cpt 10036, the provider must document the following information:

• Reason for the procedure and the need for soft tissue localization
• Imaging guidance used, such as fluoroscopy or ultrasound
• Date and time of the procedure
• Number of additional lesions marked
• Confirmation of correct device placement
• Closure of the site and application of a bandage

7. Billing guidelines

When billing for cpt 10036, it is important to ensure that the appropriate primary code, cpt 10035, is reported along with cpt 10036. This is an add-on code, and payers will not reimburse for cpt 10036 if it is reported without the primary code. Additionally, cpt 10036 should not be reported in conjunction with codes 76942, 77002, or 77012. It is important to review payer guidelines and follow any specific requirements for reporting cpt 10036.

8. Historical information

cpt 10036 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 10036

Five similar codes to cpt 10036 include:

• cpt 10035: Placement of soft tissue localization device(s) (eg, clip, metallic pellet, wire/needle, radioactive seeds), percutaneous, including imaging guidance, first lesion
• cpt 19281: Placement of breast localization device(s) (eg, clip, metallic pellet, wire/needle, radioactive seeds), percutaneous; first lesion, including mammographic guidance
• cpt 19282: Placement of breast localization device(s) (eg, clip, metallic pellet, wire/needle, radioactive seeds), percutaneous; each additional lesion, including mammographic guidance
• cpt 19283: Placement of breast localization device(s) (eg, clip, metallic pellet, wire/needle, radioactive seeds), percutaneous; first lesion, including stereotactic guidance
• cpt 19284: Placement of breast localization device(s) (eg, clip, metallic pellet, wire/needle, radioactive seeds), percutaneous; each additional lesion, including stereotactic guidance

9. Examples

1. A radiologist placing a metallic clip through a needle into a suspicious breast lesion to mark its location for a subsequent surgical procedure.
2. An oncologist inserting a radioactive seed into a tumor to mark its location for radiation treatment.
3. A surgeon placing a wire through a needle into a suspicious lung nodule to guide its removal during a surgical procedure.
4. An interventional radiologist inserting a metallic pellet into a liver tumor to mark its location for a subsequent ablation procedure.
5. A urologist placing a clip through a needle into a suspicious prostate lesion to guide a biopsy procedure.
6. A gynecologist inserting a wire through a needle into a suspicious ovarian mass to guide its removal during a surgical procedure.
7. A dermatologist placing a metallic pellet into a suspicious skin lesion to mark its location for a subsequent excision.
8. An orthopedic surgeon inserting a wire through a needle into a suspicious bone lesion to guide a biopsy procedure.
9. A neurosurgeon placing a radioactive seed into a brain tumor to mark its location for radiation treatment.
10. An interventional cardiologist inserting a clip through a needle into a coronary artery to mark the location of a stenosis for a subsequent angioplasty procedure.