Hi,
We are getting a denial for billing 19301 and 19301-59 on the same breast. Anthem is stating "Physicians and the ama agree the duplicate edit reflects a bilateral procedure and does indicate multiple partial mastectomies per breast". I cannot find anything that states this code can only be billed once per breast. There were 2 lumpectomies done through 2 different incisions and since the code description does not include (s) to indicate more than 1 lumpectomy, quadrantecomty, etc, I want to be sure the AMA has indicated this can only be billed once per breast before writing this off.
19301
Mastectomy, partial (eg, lumpectomy, tylectomy, quadrantectomy, segmentectomy);
Thank you for any references you may have.
Sue
We are getting a denial for billing 19301 and 19301-59 on the same breast. Anthem is stating "Physicians and the ama agree the duplicate edit reflects a bilateral procedure and does indicate multiple partial mastectomies per breast". I cannot find anything that states this code can only be billed once per breast. There were 2 lumpectomies done through 2 different incisions and since the code description does not include (s) to indicate more than 1 lumpectomy, quadrantecomty, etc, I want to be sure the AMA has indicated this can only be billed once per breast before writing this off.
19301
Mastectomy, partial (eg, lumpectomy, tylectomy, quadrantectomy, segmentectomy);
Thank you for any references you may have.
Sue