General Surgery Coding Alert

Question: Our surgeon placed Savi Scout reflectors to localize the tumor as the initial step while performing a partial mastectomy. Can we separately bill the Savi Scout placement, or is it bundled with the surgical code?

Codify Subscriber

Answer: Because you state that the surgeon places the Savi Scouts during the partial mastectomy procedure, you should not bill the placement separately from the appropriate procedure code, such as 19301 (Mastectomy, partial (eg, lumpectomy, tylectomy, quadrantectomy, segmentectomy)) or 19302 (… with axillary lymphadenectomy).

Savi Scouts are tiny reflectors placed to specifically demarcate the breast tumor position. As such, they are used as a breast localization device similar to clips, wires, metallic pellets, or radioactive beads. Surgeons may place these devices before the partial mastectomy or intraoperatively.

A parenthetical note under codes 19301 and 19302 states. “Intraoperative placement of clip[s] is not separately reported.”

More: CPT^® Assistant (Vol. 31, Issue 5) indicates that percutaneous breast localization devices that are “placed intraoperatively (i.e., during the skin-to-skin portion of a mastectomy procedure)” are “not … separately reportable.”

Caveat: The same CPT^® Assistant issue notes that if a device is placed in a procedure separate from the mastectomy, usually prior to performing to the 19301/19302 procedure, the device placement is separately reportable. In that case, you could report 19281 (Placement of breast localization device(s) (eg, clip, metallic pellet, wire/needle, radioactive seeds), percutaneous; first lesion, including mammographic guidance).