Breast Surgery Coding

Surgeon wants to code a 19301 and 19303 on same breast. She removed the cancer with wire markers first with the 19301 and then completed the skin sparing mastectomy - 19303. I believe she can only bill for the 19303 - is that correct? She also completed the 38525 and 38900 lymph nodes with mapping on that same side - which doesn't make any difference to the breast coding - but that was the complete procedure for the case.

re: Breast Surgery Coding

It shud be codes as 19301,38525 and 38900 as 19303 is complete mastectomy however it is skin sparing one which means it is partial as well as unilateral thats y it shud b codes as 19301

re: Breast Surgery Coding

Using 19301 for skin sparing and nipple sparing mastectomy is incorrect. I attended the Zupko Conference in February and on page 57 of the handbook it says to use 19303 for this nipple and skin sparing mastectomy. So the complete coding would be 19303, 38525, and 38900. I don't believe the 19301 for the excision of the cancer done first is allowed just because the doctor chose to remove the cancer area first with a guide wire then complete the skin sparing mastectomy. That was my question to clarify. I'm dealing with a new breast surgeon who thinks she can code for anything and everything!

re: Breast Surgery Coding

If this is the update as per the conference then it shud b coded as per u that is 19303,38525,38900.I have a doubt on this can we code both 19301 and 19303 in same cases as acc to me they cant b please do clarify thanks in advance

re: Breast Surgery Coding

and y aint u coding for placing the wire that is CPT® code 19281 placing any wire in the breast for the first lesion instead of coding 19301,19303 together??

u can code it as 19303,38525,38900,19281

re: Breast Surgery Coding

and y aint u coding for placing the wire that is CPT® code 19281 placing any wire in the breast for the first lesion instead of coding 19301,19303 together??

u can code it as 19303,38525,38900,19281