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Partial mastectomy???

  1. #1
    Northeast Kansas AAPC
    Question Partial mastectomy???
    Medical Coding Books
    Medicaid patient presents with a 10 cm mass in her right breast. Initially was seen while patient was pregnant. Biopsy showed a lactating adenoma (benign). DUe to the large size of the mass she would like it removed. My question is does this meet partial mastectomy (19301) requirements or would we just bill it out as excision of a cyst or benign (19120) tumor? They are getting plastics involved since it will leave a huge deformity on that breast. Any ideas?????

  2. #2
    The only way you can report 19301 is if attention to margin were taken and documented. Resection of benign lesions are not usually excised with attention to margins.

    You can also add a mod 22 on 19120 for the extra difficulty the size of mass presented to.


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