Wiki 19120 vs 19301

[karirhi]

I am having trouble distinguishing the difference between 19120 and 19301. I have a doctor who per the path report does a lumpectomy with frozen sections on the first session with placement of balloon sizer. Patient comes back for reexcision of close superficial margin with placement of Savvy catheter (radiation). I am having trouble deciding how to code this. HELP!!

KRhiner CPC

 

[ASC CODER]

A mastectomy is the surgical removal of breast tissue due to the presence of a cancerous or precancerous growth. Mastectomy procedures are distinguished by the amount of tissue removed and any other tissues that may be removed and can vary depending on tumor size and type, cancer stage, and whether there is lymph node involvement. The following is a brief description of the mastectomy procedures that can be reported with CPT codes.



Code 19300, Mastectomy for gynecomastia: When the gynecomastia involves the subareolar and nearby tissues, code 19300 is reported. This code defines the excision of moderate amounts of gynecomastia based upon the physician's discretion. Code 19300 is reported for male patients only, as gynecomastia is a male condition



Code 19301, Mastectomy, partial: Partial mastectomy procedures describe open excisions of breast tissue and include specific attention to adequate surgical margins surrounding the breast mass or lesion. In a partial mastectomy, a larger amount of breast tissue and some skin are removed with the tumor. This also includes removal of the lining over chest muscles below the tumor. This surgery is usually performed for stage 1 and 2 tumors. This code is reported also for the performance of a lumpectomy where the tumor and a small amount of surrounding tissue are removed.



Code 19302, Mastectomy, partial; with axillary lymphadenectomy: When a partial mastectomy is performed with removal of breast tissue, the lining over the chest muscles below the tumor, and the axillary lymph nodes, code 19302 is reported.




Code 19303, Mastectomy, simple, complete: In this procedure, the entire breast is removed, but the lymph nodes and surrounding muscle are left intact. Sometimes prophylactic surgery is performed on the opposite breast in those women who are at high risk for developing contralateral disease. A simple mastectomy, which involves the removal of only the breast tissue, may be performed.



Code 19304, Mastectomy, subcutaneous: The tumor and breast tissue are removed, but the nipple and the overlying skin are left intact. Reconstruction surgery is easier, but some cancer cells may remain. It would be appropriate to report code 19304 if, for example, gynecomastia, as described in code 19300, results in a mastectomy that involves a large portion of the anterior chest wall and the procedure is described by the physician as a subcutaneous mastectomy."

taken from codecorrect

 

[armen]

I am having trouble distinguishing the difference between 19120 and 19301. I have a doctor who per the path report does a lumpectomy with frozen sections on the first session with placement of balloon sizer. Patient comes back for reexcision of close superficial margin with placement of Savvy catheter (radiation). I am having trouble deciding how to code this. HELP!!

KRhiner CPC

CPT 19120 The physician excises breast tissue for biopsy. The physician makes an incision in the skin of the breast overlying the site of the mass. Skin and tissue are dissected from the site of the defective tissue. The lesion is removed without attention to obtaining clean margins. Bleeding vessels are controlled with electrocautery or ligated with sutures. A drain may be inserted into the wound. The incision is sutured in layered closure and a light pressure dressing is applied.

CPT 19301 The physician excises a breast tumor and a margin of normal tissue by performing a partial mastectomy by making an incision through the skin and fascia over a breast malignancy and clamping any lymphatic and blood vessels. The physician excises the mass along with a margin or rim of healthy tissue. This procedure is often referred to as a segmental mastectomy or a quadrantectomy, but is also called a lumpectomy. In 19302, an axillary lymphadenectomy is also performed. The lymph nodes between the pectoralis major and the pectoralis minor muscles and the nodes in the axilla are removed through a separate incision. A drainage tube may be placed through a separate stab incision to enhance drainage from the wound or lymphatic system. The incision is repaired with layered closure and a dressing is applied.

Hope this will help.