Segmental mastectomy with axillary sentinel node biopsy


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I need some clarification on the coding for this type of procedure. I have read all of the posts on this subject and want to clarify that I understand when to code 19301 with 38525 vs 19302.

From what I have read my understanding is the 19301 w/38525 would be used when the doctor does a partial mastectomy and biopsy of a few sentinel nodes. Where as 19302 would be used when all the axillary lymph nodes are removed.

Now it seems there was some discussion about when separate incisions are made? The surgeon I work with always uses separate incisions for these procedures.

Now, should the 38525 have a 51 or 59 modifier?

One last questions, what verbiage should I look for in the operative report to distinguish between these two coding scenarios?