# 19301 multiple times same breast



## SUEV (Jul 15, 2014)

Hi,
We are getting a denial for billing 19301 and 19301-59 on the same breast.  Anthem is stating "Physicians and the ama agree the duplicate edit reflects a bilateral procedure and does indicate multiple partial mastectomies per breast".  I cannot find anything that states this code can only be billed once per breast.  There were 2 lumpectomies done through 2 different incisions and since the code description does not include (s) to indicate more than 1 lumpectomy, quadrantecomty, etc, I want to be sure the AMA has indicated this can only be billed once per breast before writing this off. 

19301  
Mastectomy, partial (eg, lumpectomy, tylectomy, quadrantectomy, segmentectomy);  

Thank you for any references you may have.
Sue


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## dkb6126 (Aug 11, 2014)

You really should use the modifier -76 (repeat procedure by same physician) in this case, not the -59.  If they don't pay with that change - appeal with medical records.


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## cynthiabrown (Aug 20, 2014)

what about mod 51


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