kayladawnlee
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My provider documented that he performed the 19120 in the same using multiple incisions. I'm concerned about the appropriate billing. Would it be appropriate to bill 19120 twice for the same breast? I'm thinking not, since this code description states 1 or more lesions, however, I have a note that each additional incision will need a modifier. I'm thinking that is just for bilateral excisions. However, I am considering the billing of 19120-RT, 19120-51,RT. I may just be overthinking, any thoughts and opinions are welcomed.
OP NOTE AS FOLLOWS:
"Procedure:
- Right Excisional Breast Biopsy (two areas/incisions)
- Intraoperative Ultrasound Guidance, Breast
"The ultrasound with a multifrequency linear transducer was used to locate the area of concern. Operative incisions were drawn out on the breast using the guidance of the ultrasound. The ultrasound was also used to assist in the surgery when necessary throughout the procedure. We dissected through the skin with a scalpel and used both sharpe and bovie dissection to access the mass. We dissected circumferentially around the mass and area appropriately and completely.
The specimen was completely amputated from the field and it was marked appropriately prior to being sent to pathology.
Hemostasis was achieved throughout using bovie and ties as needed. The wound was irrigated out and local was injected appropriately.
The wound was closed in multiple layers and dermabond was placed on the incision for skin closure.
We performed this at the mass along the mastectomy incision first followed by the lesion closer to the sternum/midline."
OP NOTE AS FOLLOWS:
"Procedure:
- Right Excisional Breast Biopsy (two areas/incisions)
- Intraoperative Ultrasound Guidance, Breast
"The ultrasound with a multifrequency linear transducer was used to locate the area of concern. Operative incisions were drawn out on the breast using the guidance of the ultrasound. The ultrasound was also used to assist in the surgery when necessary throughout the procedure. We dissected through the skin with a scalpel and used both sharpe and bovie dissection to access the mass. We dissected circumferentially around the mass and area appropriately and completely.
The specimen was completely amputated from the field and it was marked appropriately prior to being sent to pathology.
Hemostasis was achieved throughout using bovie and ties as needed. The wound was irrigated out and local was injected appropriately.
The wound was closed in multiple layers and dermabond was placed on the incision for skin closure.
We performed this at the mass along the mastectomy incision first followed by the lesion closer to the sternum/midline."