Summary & Overview
CPT 19001: Add-on Puncture Aspiration of Additional Cyst
CPT code 19001 is an add-on CPT code for puncture aspiration of each additional cyst after the first. It identifies incremental work when multiple cysts are treated in the same encounter and matters for accurate procedural reporting and payment. As an add-on, 19001 is reported in conjunction with the primary aspirational cyst procedure to reflect additional physician work and resources. Nationwide, correct use of this code supports accurate utilization tracking and ensures clinicians are compensated for additional procedures when multiple cysts are treated.
Key payers in this national overview include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The analysis addresses how 19001 is used across clinical settings and payer policies that commonly affect coverage and billing for add-on procedures.
Readers will learn: the clinical context for reporting 19001 (when multiple cyst aspirations occur), typical sites of service, common payer considerations, and areas where policy or billing guidance commonly affects reimbursement. If specific national benchmarks, payer-specific edits, or local coverage determinations are relevant, they will be summarized; where input data is missing, the text will note that limited information was available. This piece focuses on procedural definition, reporting context, and the operational implications of using an add-on CPT code for additional cyst aspirations.
Billing Code Overview
CPT code 19001 is an add-on procedure for the puncture aspiration of an additional cyst after the first cyst has been aspirated. The description indicates the provider performs puncture aspiration of each additional cyst; separately reportable image guidance may be used during the procedure.
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Service type: Percutaneous cyst aspiration (add-on) following initial cyst aspiration
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Typical site of service: Ambulatory surgical center or hospital outpatient setting; may also be performed in an office or clinic setting depending on clinical context and imaging availability
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A 48-year-old female with multiple symptomatic simple ovarian cysts presents to an outpatient interventional radiology suite for image-guided cyst aspiration. The patient previously underwent aspiration of the largest cyst (reported with the base code) earlier in the session. The provider performs percutaneous puncture aspiration of an additional cyst during the same encounter. Ultrasound guidance is used and documented. The workflow includes pre-procedure consent and history, ultrasound localization and sterile preparation, local anesthesia, percutaneous needle insertion with aspiration of cyst contents, sample collection for cytology if indicated, hemostasis, and post-procedure observation with discharge instructions. The encounter is billed as an add-on procedure for each additional cyst aspirated beyond the first, with separate reporting of image guidance if billed independently.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
59 | Distinct procedural service | Use when the aspiration of an additional cyst is distinct from another service performed on the same day but not normally reported together. |
76 | Repeat procedure or service by same physician |