Wiki Breast cancer coding question

[Coastal Coder]

Good Morning,

I was just having a discussion with one of my surgeons in regard to some things she learned at a conference and I wanted to see if this is true or not.

She was told that if she removed multiple tumors thru the same incision that she could charge for separately for each one (19301) as long as they were breast cancer. If the tumors are benign then you can only charge one code. I have never heard this and I told her we could not do that, but I wanted to get some feed back before I tell her no for sure.

Thanks for any help

Michelle

 

[Bwray]

Coding for Breast Surgery

Hi Michelle,

I would agree with you on CPT code 19301 (lumpectomy or partial mastectomy) being used one time per surgery. The procedure includes margins so we know additional tissue is being taken at the same time the cancer is removed, if the pathology report shows the margins positive for cancer cells, I would report CPT code 19301-58, return to the OR for additional surrounding tissue excision. Tumors that are benign are coded CPT code 19120 because margins are not taken.

Hope this helps,
Brenda