Having said that I had been thinking of the real urging medical necessity for the procedure for the physician to accomplish; medical necessity in the sense that with the scenario given forth, I wonder why the lesion in the axillary node with all its suspesion can not be correlated with Breast lesion and consider the axillary node lesion as one related to breast lesion. May be it is an axillary tail of the breast components !!??
If I make some sense in this, when a lesion can be preoperatively marked by placing thin wire (radiologic marker) down to the lesion (19290), the lesion in the axillary region be it lymph draining that area of the breast, or the tail of the axillary region of breast tissues, we can CODE IT AS 19290, for any of these lesions.
Also I would like to say that the breast tissues components are: the four quadrants , areola and nipple area, and the axillary tail of the breast.
Having that in mind the code 19290 can be thoughtfully appropriated for the wiring of the axillary region mass, be it lymph tissues/lymphatics draining the axillary tail and the upper quadrant preoperatively, once the doctor feels or finds the medical necessity for that. WHY NOT? Hi, it is only a suggestion.
Discuss with your physician; you would come to the answer for this real challenge.
Thank you for listening!