Breast Surgery 19101/19125

jewlz0879

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Hello fellow coders,

I'm new to General Surgery and have been sorta stumped on something and would love some clarification to ensure I'm coding correctly. Please see Op note below:

Patient underwent wire localization of the right breast. She was taken to the operating room. She was anesthetized in supine position. The wire was trimmed externally, and she was prepped with Betadine and draped in sterile fashion. I created a curvilinear incision in the superior aspect of her right breast. The area of interest was excised with electrocautery, and a short stich was placed. The wound was irrigated ect.

How do I know when to use plain 19101 or 19125? Would I use 19125 here since she underwent the wire localization? And upon reading this article: http://health-information.advanceweb.com/Article/Coding-Breast-Diseases-and-Surgery-Part-1.aspx it says to also bill for 19290.

So, given my op report would I bill 19125 and 19290? Any guidance or tips are greatly appreciated!
 

syllingk

Expert
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Boise, Idaho
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Did your surgeon place the wire loc? I agree that this looks like 19125. You would bill the 19290 only if your doc placed the guidewire but I think radiology usually does that.
 

koatsj

Guru
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Wisconsin Dells, WI
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My surgeons have told me that if they take additional margins of breast tissue because of malignancy in addition to the wire, I am to bill 19301. If they are just removing the wire, I am to bill 19125. CPT 19101 is used if a biopsy is done on the mass. It is not completely excised. My doctors don't place the wire. That is done in radiology. I don't bill 19290 ever. I would go with 19125. Hope this helps :)
 
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jewlz0879

True Blue
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Location
Richardson, TX
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Did your surgeon place the wire loc? I agree that this looks like 19125. You would bill the 19290 only if your doc placed the guidewire but I think radiology usually does that.

Thank you! I was wondering about that. I will have to email the manager and find out; I do contract coding for a company and do not have access to the physician but I'm sure my manager can contact them and find out.
 
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