CPT Code 10005: Fine Needle Aspiration Biopsy Including Ultrasound Guidance, First Lesion

CPT code 10005 covers fine needle aspiration biopsy with ultrasound guidance for the first lesion, including imaging interpretation and documentation.

Use Code

What is FNA with ultrasound guidance?

CPT code 10005 is used to report a fine needle aspiration (FNA) biopsy performed under ultrasound guidance, including imaging documentation and interpretation, for the first lesion. It is commonly used for thyroid nodules, lymph nodes, breast masses, or soft tissue lesions. This fine needle aspiration biopsy is often guided by the same imaging modality throughout the procedure.

This code includes both the procedure and the real-time ultrasound guidance, replacing older combinations of 10021 + 76942. The code is maintained by the American Medical Association and represents a primary procedure when the FNA biopsy is performed using ultrasound.

CPT 10005 documentation requirements

For documentation, it's important to prepare the following:

Clinical indication and location of lesion (e.g., thyroid nodules, same lesion or separate lesion)
Real-time ultrasound guidance details (device used, settings, imaging modality such as computed tomography or magnetic resonance)
Number of passes and technique (e.g., FNA, fine needle aspiration FNA, capillary sampling)
Documentation of ultrasound images and interpretation
Immediate post-procedure patient status and complications (if any)

Images and interpretation must be stored and available for review to accurately report fine needle aspiration procedures using the correct CPT code.

CPT code 10005 billing guidelines

To make reimbursement smooth, keep in mind the following:

Report once per encounter per first lesion.
For additional lesion or separate lesion, report 10006.
Do not bill 76942 separately—ultrasound guidance is included.
Ensure both technical and professional components are supported if billing globally.

Modifier -26 (professional component) or -TC (technical component) may be used when appropriate, especially when the FNA procedures involve the same session or same type of imaging modality.

Other relevant CPT codes

10006 – FNA with ultrasound guidance, each additional lesion (add on code; list separately in addition to primary code)
10007/10008 – FNA with fluoroscopic guidance or CT guidance (computed tomography)
10021 – Fine needle aspiration without imaging guidance