It depends on the documentation and insurance carrier. If the partial mastectomy was done with preoperative placement of radiological markers to help with the guidance as to where the lesion may be, then you can use 19125, then the add on code. If the excision inhibits extra attention to additional margins, then that can be coded as 19301, even with radiological markers guidance.
If the documentation justifies the two separate excisions on one breast, then I think it would be okay to use a 59 on one.
Also use supporting Dx, history, and status...ECT...
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