Wiki BREAST CPT

[annettebec]

Clinical History
Pre-op diagnosis:
BREAST ASYMMETRY BETWEEN NATIVE BREAST AND RECONSTRUCTED BREAST
.
Final Pathologic Diagnosis
A. Right breast mass, history of right breast cancer, excision:
Benign skin and breast parenchyma with foreign body giant cell reaction and grossly identified
metallic clips consistent with previous biopsy site changes
2 lymph nodes, negative for carcinoma

Gross Description
A. Breast
Received fresh designated "right breast mass, history of right breast cancer" is a 3.5 x 2.5 x 1.0 cm aggregate of
skin and yellow-white fibrofatty tissue. Sectioning reveals small metallic clips within fibrous tissue consistent with
previous biopsy site. Representative portions of skin and fibrofatty tissue are selected for frozen section and are
subsequently thawed and placed in cassette A1. The remaining tissue is entirely submitted in cassette A2.

What CPT would you assign? Any help appreciated

 

[danachock]

Hi annettebec,
Ouch this is definitely one of those cases. I would have treated this like a lumpectomy. This wasn't a core biopsy and it wasn't mammoplasty. This was a excision that was a right breast mass excision that would lead me to assigning a 88307. Lumpectomy (even as thin as this presents) is still allowed 88307.
Again, I do not believe this is a biopsy. The fact that representative sections were selected for frozen and thawed had me leaning towards a different CPT assignment but I'll remain with the 88307 assignment for this accession that some form of lumpectomy was performed that didn't require review of margins (that is not stated within the pathology report, nothing was inked an no indication that it was performed) to drive a 88307 charge instead of a 88305 charge.
I would like to hear if anyone disagrees with my summary and why.
Thank you for listening and have a great evening,
Dana Chock

 

[annettebec]

Hi annettebec,
Ouch this is definitely one of those cases. I would have treated this like a lumpectomy. This wasn't a core biopsy and it wasn't mammoplasty. This was a excision that was a right breast mass excision that would lead me to assigning a 88307. Lumpectomy (even as thin as this presents) is still allowed 88307.
Again, I do not believe this is a biopsy. The fact that representative sections were selected for frozen and thawed had me leaning towards a different CPT assignment but I'll remain with the 88307 assignment for this accession that some form of lumpectomy was performed that didn't require review of margins (that is not stated within the pathology report, nothing was inked an no indication that it was performed) to drive a 88307 charge instead of a 88305 charge.
I would like to hear if anyone disagrees with my summary and why.
Thank you for listening and have a great evening,
Dana Chock