Outpatient Facility Coding Alert
Rely on 19499 for Unlisted Breast Procedures
Question: A patient had a mastectomy and had to be brought back to the operating room to look for a bleed as she developed a hematoma at the surgical site. The physician explored the wound for the bleed and cauterized two different areas. What CPT(R) code would I assign for the reopening of the surgical wound with cauterization?
Ohio Subscriber
Answer: Since there is no proper code for this particular procedure, you have to resort to unlisted code 19499 (Unlisted procedure, breast). You can use 19499 for any breast procedure that cannot be reported using any of the available codes. It is better to consult the physician to ensure that proper documentation has been done before billing for an unlisted procedure.
You’ll need to add modifier 78 (Unplanned return to the operating/ procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period), as it is an unplanned return to the operating room during the postoperative period.
Related Articles
Outpatient Facility Coding Alert
- Coding Update:
Combat the Challenges of Coding Symptoms and Definitive Diagnoses for Outpatient Services
Hint: Understand the disease process and its associated symptoms. Knowing how to code when reporting [...] - Skin Care:
Know What to Look for to Peel off the Ambiguity of Skin Coding
Look into the elements of skin procedures before coding. Although there have been no recent [...] - ICD 10:
Transition of Chronic Laryngitis Will Be a Simple Switchover to a J Code
Remember to report exposure to tobacco or infectious agents separately. If your physician diagnoses a [...] - Reader Questions:
Align Arthroplasty Coding With 28285
Question: Our physician recently performed “Arthroplasty/arthodesis of the second and third digits” and an “arthroplasty only [...] - Reader Questions:
Rely on 19499 for Unlisted Breast Procedures
Question: A patient had a mastectomy and had to be brought back to the operating room [...] - Reader Questions:
Grasp the Group Therapy with 97150
Question: What code(s) should be used to bill for a Medicare patient’s participation in group [...] - You Be the Coder:
Know How to Use 90792
Question: How and when should code 90792 be billed? New Mexico Subscriber Answer: This code [...]
