Clinically enlarged cervical lymph nodes with a history of thyroid cancer are usually assessed by fine-needle aspiration biopsy (FNAB) followed by a cytology. Thyroglobulin (Tg) is frequently elevated in malignant FNAB needle wash specimens and it's use may possibly augment or replace cytology.
A 25-gauge needle is inserted obliquely within the transducer plane
of view and moved back and forth (passes) through the nodule to
compensate for patient movement and needle deflection. There is no
suction device; cells move into the needle via capillary action. After
collection of the cytology samples, withdraw between 0.10 and 0.25
mL of saline up through each needle and empty this fluid back
through the needle into a tube. This is the needle washing used for
analysis. Repeat the passes and saline washings from the same
biopsied site and empty contents into the same tube. The washes from
all needles are pooled (final volume 1 mL). Inspect specimen for
visible blood or tissue contamination. If bloody, centrifuge
specimen and transfer supernatant to a new tube to send to the
laboratory. The supernatant, not the cellular materials, is used for
analysis. If the specimen is clear, centrifugation is not necessary.
Freeze immediately and transport frozen sample to laboratory directly.
Do not send specimens in glass tubes.
Tuesday, Thursday, Saturday
Reported (Analytical Time)
The CPT codes provided are based on AMA guidelines and are for informational purposes only.
CPT coding is the sole responsibility of the billing party.
Please direct any questions regarding coding to the payer being billed.
Preferred: 1 mL (0.8 mL minimum) Fine Needle Aspirate (FNA) or thyroid tissue washings collected in a sterile transport tube Other Acceptable Specimens: Non-lymph node, non-nodal soft tissue, or cervical node washings Reject Criteria: Glass tubes Transport Temperature: Frozen Methodology: Beckman Coulter Chemiluminescent