AAPC - Back to school
Results 1 to 10 of 10

Thread: Breast needle localizations

  1. #1

    Cool Breast needle localizations

    AAPC: Back to School
    Can someone help me when a Breast lumpectomy with needle localization is performed which code is correct the 19125 or 19301. There is no documentation anywhere to support using one or the other. Thanks
    Last edited by ldolyak; 01-10-2008 at 09:44 AM.

  2. #2
    Join Date
    Apr 2007
    St. Louis, Missouri


    I would use 19125

    Melissa Blow, CPC

  3. #3


    I Would Use 19301 Depending On The Size Of The Lump Removed. The
    Payment Would Be Higher From Ins. Company Assuming This Is Not
    A Self-pay Patient.

  4. #4
    Join Date
    Apr 2007


    I have been told that you can use 19301 if a quadrant of the breast was removed or if you are excising to get clear margins for a patient diagnosed with cancer. If you don't meet the above criteria I have been told to use 19125.

  5. #5
    Join Date
    Apr 2007
    Las Vegas


    I've used 19125 if the doc uses the clips and doesn't mention clear margins. If he does say that he took care to get margins, then I would use 19301. Hope that this helps.
    Malama pono,

    Sundae Yomes

  6. #6

    Default 19125 and 19301

    If a 19125 specimen was sent to pathology and from that result surgeon has to perform a 19301. Can you use a modifier 58 and document both codes?

  7. #7
    Join Date
    Apr 2007


    the 19125 bundles with the 19301 per the CCI edits.

  8. #8
    Join Date
    Apr 2007
    Albany, New York


    If 19125 is performed initially, and the surgeon subsequently goes back to get "margins", I do not use 19301. (the description of that code in Coders' Desk Reference states the lump/ mass is removed a margin of healthly tissue).

    If subsequent surgery is done to remove additional tissue (margin),
    I use 19120 (excison of breast tissue).

    Karen Maloney, CPC
    Data Quality Specialist

  9. #9


    The problem I run into is 19125 specifies w/ radiology markers, and 19120 doesn't. My doctor doesn't always include this in his documentation but it's closer to what he actually does. I need to talk to him, but he's not one to listen well. Any suggestions?
    adrianne, cpc

  10. #10


    If, during the initial procedure, seemingly normal tissue is taken in an effort to get clear margins for either invasive cancer or DCIS, I use 19301. If only the abnormal tissue itself is being removed, I use 19125 (or if no localization, 19120). In either case, if a later return is required to get additional tissue for clear margins on CA or DCIS, I use 19301, with the 58 modifier if, as is usually the case, the return is w/in 90 days. I don't understand the point about the desk reference definition - if it's that the "mass" - or most of it - has already been removed, then 19120 seems LESS appropriate to me. Its actual CPT definition states cyst/tumor/lesion/aberrant breast tissue, whereas 19301 just states partial mastectomy, followed by some examples in parentheses. (I always have to put a note in my book: e.g.=for instance; i.e.=that is). So if most or even all of the additiional tissue removed turns out to be "normal", I can't see where 19120 is better than 19301. Just my opinion.
    C.Martin CPC-GENSG

Similar Threads

  1. Needle localization of breast
    By codedog in forum General Surgery
    Replies: 4
    Last Post: 05-23-2011, 10:57 AM
  2. Preoperative placement of needle breast bx
    By roxaneas in forum General Surgery
    Replies: 1
    Last Post: 03-23-2011, 03:14 PM
  3. Stereotactic Breast Needle Bx
    By Kevinph84 in forum Outpatient Facilities
    Replies: 0
    Last Post: 01-30-2010, 08:03 AM
  4. Needle-Localized Breast Biopsy??
    By GuzmanS in forum General Surgery
    Replies: 5
    Last Post: 12-14-2009, 11:26 AM
  5. Rt Breast Bx with needle localization
    By Trendale in forum General Surgery
    Replies: 3
    Last Post: 07-10-2008, 08:08 AM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts

Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.