Lynn Pegram CPC CPCI CGSC CEMC MidAtlantic Coding LLC wwwcodingprosnet LynnPegramaolcom 8044743325 Disclaimer This material is designed to offer basic information on coding for breast procedures This information is based on the experience training and the interpretation of ID: 649319
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Coding Breast Procedures
Lynn Pegram, CPC, CPC-I, CGSC, CEMCMid-Atlantic Coding, LLCwww.codingpros.netLynnPegram@aol.com804-474-3325Slide2
Disclaimer
This material is designed to offer basic information on coding for breast procedures. This information is based on the experience, training, and the interpretation of the author. Although the information has been carefully researched and checked for accuracy and completeness, the instructor does not accept any responsibility or liability with regard to errors, omissions, misuse, or misinterpretation. This handout is intended as an educational guide and should not be considered a legal/consulting opinion. Slide3
BREAST
PROCEDURESSlide4Slide5Slide6Slide7Slide8Slide9Slide10Slide11Slide12Slide13Slide14
Non-Invasive Breast Procedure
Mammotome Breast BiopsySlide15Slide16Slide17
PROCEDURE:
MAMMOTOME BREAST BIOPSYPre-op Dx: Mass, right breastPost-op Dx: Mass, right breast
Surgeon:
Dr Addison Montgomery
Anesthesia:
LocalSlide18
CODING SOLUTION:
CODES: 19103 – RT – Percutaneous automated vacuum assisted biopsy device; using imaging guidance 19295 – Image guided placement, metallic localization clip, percutaneous
76942 -
Ultrasonic guidance for needle placement (biopsy, aspiration, localization device)Slide19
Left Simple mastectomy with
inraoperative lymphatic mapping and left axillary sentinel node dissection.
Coding Scenario
Codes: 19303-LT (174.4)
38525-LT (229.0)
38900 (229.0)Slide20
Left simple mastectomy with
intraoperative lymphatic mapping and left axillary sentinel node dissection.Codes: 19303-LT - Total/Simple Mastectomy
38525-LT -
Excision
Axillary
Node
38900 -
Mapping of Sentinel Node
Rationale:
This was coded as simple (Total) mastectomy. The 38525 is coded for the sentinel node excision. The 38900 is for the mapping of the node. Slide21
Coding Scenario
Partial Right Mastectomy w/positive sentinel node biopsy,Complete Axillary Node Dissection w/lymphatic mapping.
Codes:
19302-RT (174.2) (196.3)
38900 (196.3)Slide22
Coding Scenario
Total Left Mastectomy w/positivesentinel node biopsy, complete axillarynode dissection and lymphaticmapping.
Codes:
19307-LT (174.3) (196.3)
38900 (196.3)Slide23
Coding Scenario
Bilateral Simple Mastectomy, RightBreast Cancer, Left Prophylactic Codes:19303-RT (174.4)19303-59LT (V50.41) (V16.3)Slide24
Coding Scenario
Bilateral Mastectomies w/bilateralsentinel node biopsies w/lymphatic mapping that came back negativeCodes: 19303-50 (174.2)38525-50 ( 229.0)
38900 x 2 (229.0)Slide25
Coding Scenario
Right Needle Loc Breast Biopsy for a Breast Mass Code: 19125-RT (611.72)A Week LaterRight Partial Mastectomy for Carcioma In-situ
Code: 19301-58RT ( 233.0)
Slide26
Coding Scenario
Right Breast Cyst Aspiration x 4 w/ultrasound guidanceCodes: 19000 – RT (610.0)19001 x 376942-26Slide27
Question
And AnswerSlide28
Thank You and enjoy
the rest of your conference!