Summary & Overview
CPT 48102: Percutaneous Pancreatic Needle Biopsy, Tissue for Pathology
CPT code 48102 represents a percutaneous, image-guided pancreatic needle biopsy with tissue sent for pathological analysis. This procedure is clinically important for diagnosing pancreatic masses, distinguishing malignant from benign lesions, and guiding oncologic and surgical management. Nationally, accurate coding for percutaneous pancreatic biopsy affects care documentation, appropriate utilization of interventional radiology resources, and proper claims processing across public and commercial payers.
Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The summary addresses coverage and coding consistency among these major payers and highlights the clinical context for use of the code.
Readers will find a concise review of the clinical indication and typical care setting for 48102, common billing considerations, and the types of benchmarks and policy updates relevant to this service. The content provides guidance on where the procedure is typically performed, how it is recorded for pathology follow-up, and what to expect in payers’ administrative handling. Data not available in the input is noted where payer-specific coverage policies, associated taxonomies, and ICD-10 pairings would normally appear.
Billing Code Overview
CPT code 48102 describes a percutaneous needle biopsy of the pancreas in which the provider obtains tissue samples and sends them for pathological analysis. The service type is a percutaneous image-guided pancreatic biopsy. The typical site of service is an outpatient interventional radiology suite or other procedural area where percutaneous image-guided biopsies are performed.
Clinical & Coding Specifications
Clinical Context
A typical patient is a 58-year-old individual with a pancreatic mass identified on cross-sectional imaging (CT or MRI) presenting with abdominal pain, weight loss, and/or jaundice. The interventional radiology team evaluates imaging and medical history, obtains informed consent, and performs a percutaneous, image-guided pancreatic needle biopsy (CPT 48102). Under conscious sedation or monitored anesthesia care, the operator uses ultrasound or CT guidance to advance a coaxial needle into the pancreatic lesion, obtain core and/or fine-needle aspirate samples, and send specimens to pathology for cytology and histology. Post-procedure, the patient is observed for bleeding or pancreatitis, receives activity restrictions and discharge instructions, and pathology results guide oncology, surgery, or gastroenterology treatment decisions.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
11 | Office or other outpatient visit for evaluation and management | When reporting an E/M visit on the same day as the procedure that meets separate reporting criteria and payer rules |
22 | Increased procedural services |