nsteinhauser
Expert
If anyone can shed light / share credible documentation, I'd sure appreciate it.
The patient had 2 suspicious areas of the same (right) breast identified preoperatively by 2 separate needle localizations (2 separate wires and clips.)
The surgeon identified both and excised both OUT OF THE SAME INCISION. They were next to each other.
I've was taught long ago that if something was excised out of the same incision as something else, you can't separately code for both. So I think the appropriate coding is 19125 - RT.
However, I just got done reading a similar coding question on a SuperCoder page that instructed that as long as there were 2 "separately identified preoperatively" lesions, you should code the 19125 AND the 19126. I think using the 'they were separately identified' argument and not caring about only one incision vs. 2.
Does anyone have any documentation addressing this? CPT Ass't March 2015 states you can only code per incision, not based on how many WIRES were preoperatively placed, but doesn't say 'not based on how many LESIONS were removed.'
Thanks in advance!
The patient had 2 suspicious areas of the same (right) breast identified preoperatively by 2 separate needle localizations (2 separate wires and clips.)
The surgeon identified both and excised both OUT OF THE SAME INCISION. They were next to each other.
I've was taught long ago that if something was excised out of the same incision as something else, you can't separately code for both. So I think the appropriate coding is 19125 - RT.
However, I just got done reading a similar coding question on a SuperCoder page that instructed that as long as there were 2 "separately identified preoperatively" lesions, you should code the 19125 AND the 19126. I think using the 'they were separately identified' argument and not caring about only one incision vs. 2.
Does anyone have any documentation addressing this? CPT Ass't March 2015 states you can only code per incision, not based on how many WIRES were preoperatively placed, but doesn't say 'not based on how many LESIONS were removed.'
Thanks in advance!