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mastectomy

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    Wiki bilateral mastectomy with prophylactic breast ?

    Hello! I am wondering if anyone has had the following denial and if so how did you fight it with insurance. We recently had a patient come in for a bilateral mastectomy. One side had cancer and the other doctors did a prophylactic removal of breast. The CPT code that was used was 19303 with...
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    Wiki Radical Mastectomy WITHOUT lymph nodes???

    Hi everyone. I am not allowed to post the op note but here is a summary. Patient has a tumor that invaded the pectoralis major. We did a mastectomy including a pectoralis major resection. No axillary lymph node were taken. 19307-52 or 19303-22?? I am stumped
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    Wiki Completion Mastectomy

    This patient had a mastectomy in 2012 and had a recurrence and we performed a completion mastectomy with reconstruction. Do we need to append any modifiers to indicate that this is a completion procedure? Indication for Surgery xxx is a pleasant 51 year old female with history of Stage II...
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    Wiki More clarification of 19301 vs 19125

    I am looking at multiple op reports where there is needle localization, clearly documented in the op report and a radiologist report, where the surgeon does a "deep dissection" around the needle/wire and completely excises the tissue and wire and it is sent to radiology for confirmation that...
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    Wiki Mod 79, 78 or 58 for Port A Cath

    Hello, we did a modified radical mastectomy on a patient and they are in the global. We are now doing a port-a-cath placement for their chemo. Would that be considered unrelated? At the same time the Dr also drained a seroma from the mastectomy site. I am thinking that would be a mod-78, so...
    • shellabell32
    • Thread
    • drained mastectomy port-a-cath seroma time
    • Replies: 2
    • Forum: Modifiers
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    Wiki Multiple PQRS codes for same case?

    Can 3260F and 3250F appear on the same case? I'm a coder, not a biller, so I'm not sure who this would get billed out line by line. For example, a breast cancer case includes the mastectomy and 3 sentinel nodes for 88307 X 4. The mastectomy documentation qualifies for 3260F, however the...
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    Wiki Breast Reconstruction

    Bilateral mastopexy augmentation is the procedure performed. I think I might be reading into it too much and confusing myself. I was thinking 19316 and 19325 both with a modifier 50. However, I have been looking at 19342, however the patient did not have a mastectomy...
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    Wiki 19302 vs 19301 & 38525

    does anyone have documentation stating how sentinel node biopsies are to be billed? If the surgeon removes 3 lymph nodes because they're blue, via a seperate incision but during a lumpectomy procedure (The injection would be billed with either coding option) my physician wants to bill a 19301...
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    Wiki Segmental Mastectomy w/ additional margin excision

    Are re-cuts to the margin of a surgical eval & micro billed separately or should they be bundled into the primary surgical pathology code? I have a case for a localized segmental mastectomy with 2 specimens labeled: 1 Additional left breast medial-inferior margin,excision Breast tissue, no...
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