Need breast surgery guru help!!

mizzmaryb

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Please please please can someone please explain to me the difference between 19303 coded out with 38525 vs 19307.
i understand the modified radical mastectomy can be with or without pectoralis minor muscle taken but excludes major.

This is what i'm understanding...
from documentation if 19303 is valid and only a few axillary lymph nodes are dissected then 38525 would be paired w it?
is the 19307 description meaning ALL of axillary lymph nodes? or some or both?

i'm very confused. i'm wondering if it could be the dr's op note as well that is confusing me. if i need to post it up please let me know.....

thank you!!! :)
 

mizzmaryb

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is the determination based off of separate incision into the breast/axilla?
two diff incisions then code out 19303 and 38525/38500 (based off level)

all removal done through same incision, code out 19307?
 

surgonc87

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In my opinion, 19307 would have to constitute for total lymphadenectomy and 19303, 38252-m-58 would constitute for biopsy sent out to lab, frozen section to determine if Dr. will proceed with total lympadenectomy. In that case, you would report 19307, 38900 without the biopsy...
mS
 

mizzmaryb

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thank you ms.

from research this is what i'm starting to think too. i just read a thread on this and the talk about separate incisions is now throwing me off.
the surgeon did a 19303-LT with 38525 and then it looked like a 19303-RT but the 2 nodes he removed and sent to pathology came back postive for metastatic carcinoma. that's when the decision for axillary dissection was made.
 
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