This is a modified radical mastectomy (19307) with sentinel node mapping procedure (38900). Can I use multiple codes for this procedure? When a total mastectomy with sentinel node biopsy is performed, I obtain a frozen section of the nodes and proceed to dissect the axilla if positive. Total mastectomy with sentinel node biopsy uses codes 19303, 38525-51, and 38900. ![]() Therefore, lumpectomy with sentinel node biopsy is billed using codes 19301, 38525-51, and 38900. Code 38900 is an add-on code to be used with any lymph node biopsy or lymphadenectomy code to indicate the intraoperative work done to identify the sentinel lymph nodes. When sentinel lymph node biopsy was developed, the code needed to be applied to both breast and melanoma procedures. Modified radical mastectomy is coded 19307 lumpectomy with axillary dissection is coded 19302. The breast surgery Current Procedural Terminology (CPT) codes were developed when axillary dissection was standard therapy for breast cancer. Why are there two separate codes to report for breast cancer operations with sentinel node biopsy and one unified code for mastectomy or lumpectomy with axillary node dissection? This column responds to some frequently asked coding questions related to breast cancer operations, sentinel node biopsy, ultrasound-guided core biopsies, excision with wires, intraoperative assessment of margins, and more. Consequently, the American College of Surgeons (ACS) General Surgery Coding and Reimbursement Committee (GSCRC) often receives questions about coding, particularly for breast surgery. How do you code for ablation of breast lesions with cryotherapy, microwave, RFA, or laser?Ĭoding for surgical services can be complicated due to the numerous rules, guidelines, and exceptions-all of which the Centers for Medicare & Medicaid Services frequently updates and revises.How do you code for intraoperative radiation or placement of the different devices for brachytherapy?. ![]()
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