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Need Help Clarifying Breast Excision - CPT 19125 or 19120?? - fibroadenoma

G

ginger43

Guru
Messages
180
We need help deciding between CPT 19125 or CPT 19120 for the following scenario:

The patient came in our facility with a clip that was placed a few days prior in ANOTHER facility. Our radiology did verify clip placement.
The surgeon did an excision of a fibroadenoma of the breast with the clip still in place.

We are uncertain which CPT is appropriate because CPT codebook does not clarify 19125 stating this procedure is done WITH or WITHOUT clip placement at the time of procedure; and there was a clip present that we did not place.

We were leaning towards using 19125 since it does not really clarify that we had to place the clip, but the clip was there.... but we would like to see if anyone has any thoughts that could help figure this out.

We looked at a few CPT assistants and could not get a good answer there or at least on the ones we were viewing.

Thanks! :D
 
CPT 19125 or 19120?

elizabeth24 said:
We need help deciding between CPT 19125 or CPT 19120 for the following scenario:

The patient came in our facility with a clip that was placed a few days prior in ANOTHER facility. Our radiology did verify clip placement.
The surgeon did an excision of a fibroadenoma of the breast with the clip still in place.

We are uncertain which CPT is appropriate because CPT codebook does not clarify 19125 stating this procedure is done WITH or WITHOUT clip placement at the time of procedure; and there was a clip present that we did not place.

We were leaning towards using 19125 since it does not really clarify that we had to place the clip, but the clip was there.... but we would like to see if anyone has any thoughts that could help figure this out.

We looked at a few CPT assistants and could not get a good answer there or at least on the ones we were viewing.

Thanks! :D
Click to expand...


Was the patient sent from the other facility and why did they place the clip? Did your surgeon plan a preoperative placement of radiological marker?
 
hedmiston said:
Was the patient sent from the other facility and why did they place the clip? Did your surgeon plan a preoperative placement of radiological marker?
Click to expand...

19125 as the code description states" identified by preoperative placement of marker" doesn't state who has to put it in. it is usually done by radiology ahead of time.
 
19125 is appropriate

[I use this when clip in place don't matter who placed it. your path report should say clip in specimen



QUOTE=elizabeth24;384013]We need help deciding between CPT 19125 or CPT 19120 for the following scenario:

The patient came in our facility with a clip that was placed a few days prior in ANOTHER facility. Our radiology did verify clip placement.
The surgeon did an excision of a fibroadenoma of the breast with the clip still in place.

We are uncertain which CPT is appropriate because CPT codebook does not clarify 19125 stating this procedure is done WITH or WITHOUT clip placement at the time of procedure; and there was a clip present that we did not place.

We were leaning towards using 19125 since it does not really clarify that we had to place the clip, but the clip was there.... but we would like to see if anyone has any thoughts that could help figure this out.

We looked at a few CPT assistants and could not get a good answer there or at least on the ones we were viewing.

Thanks! :D[/QUOTE]
 
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