General Surgery Coding Alert

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Does Needle Placement Alter Lumpectomy Code?

Question: A patient had mammographic-directed needle localization of the tumor. The surgeon made an elliptical skin incision directly over the tumor and used electrocautery to divide the subcutaneous fatty tissue and to dissect through breast tissue. The surgeon continued dissection with the electrocautery until the mass, including the localization wires, were removed and included with the specimen as well. The pathology states "lumpectomy, left breast with needle localization, measuring 11 x 8 x 4 cm. Benign dystrophic calcification." Should I code this procedure with 19301-LT or 19125-LT? Louisiana Subscriber Answer: You should use 19301 (Mastectomy,partial [e.g., lumpectomy, tylectomy, quadrantectomy, segmentectomy]). You do not need modifier LT (Left side), however, unless your surgeon was also performing another procedure on the right side and you need to distinguish which procedure was done on which side. From the procedure's description , it doesn't seem like your provider participated in the localization process, so [...]
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