Wiki Breast lipoma

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bethh05

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Ok, I am trying to rationalize what CPT to use for excision of a breast mass, pathology states lipoma. I was going to use 19120, being it is an excision of breast mass, but then maybe 215xx being it is a lipoma, not a neoplasm or cyst? Any help is greatly appreciated!
 
If the mass was completely removed using open surgical technique without preoperative wire/marker localization, then 19120 is correct. However, if a localization wire or metallic marker had been placed into the lesion prior to the surgical removal (which is becoming standard of care) then 19125.

If it was "excised" during a image-guided INCISIONAL percutaneous core biopsy, then you will bill it with the 19081-19086 codes.

Typically, the patient first has an image-guided core biopsy with marker placement to find out the initial pathology (performed in radiology dept), then the breast surgeon performs the open surgical excision of the mass following the marker as a guide. It is rare than surgeons go straight to open surgery on a breast mass anymore.

Hope this helps. I have 19+ years in breast imaging coding/billing and will be more than happy to help you in the future.

Holly Giffin, CPC
Physician Coding Auditor
 
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