1. Coding Breast Procedures
Lynn Pegram, CPC, CPC-I, CGSC, CEMC
Mid-Atlantic Coding, LLC

2. 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.

3. BREAST
PROCEDURES

14. Non-Invasive Breast Procedure Mammotome Breast Biopsy

17. PROCEDURE: MAMMOTOME BREAST BIOPSY
Pre-op Dx: Mass, right breast
Post-op Dx: Mass, right breast
Surgeon: Dr Addison Montgomery
Anesthesia: Local

18. CODING SOLUTION:
CODES: – RT – Percutaneous automated vacuum assisted biopsy device; using imaging guidance
19295 – Image guided placement, metallic localization clip, percutaneous
Ultrasonic guidance for needle placement (biopsy, aspiration, localization device)

19. Coding Scenario
Left Simple mastectomy with inraoperative lymphatic mapping and left axillary sentinel node dissection.
Codes: LT (174.4)
38525-LT (229.0)
38900 (229.0)

20. Left simple mastectomy with intraoperative lymphatic mapping and left axillary sentinel node dissection.
Codes: LT - Total/Simple Mastectomy
38525-LT - Excision Axillary Node
Mapping of Sentinel Node
Rationale: This was coded as simple (Total) mastectomy. The is coded for the sentinel node excision. The is for the mapping of the node.

21. Codes: 19302-RT (174.2) (196.3) 38900 (196.3) 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)

22. Coding Scenario
Total Left Mastectomy w/positive
sentinel node biopsy, complete axillary
node dissection and lymphatic
mapping.
Codes:
19307-LT (174.3) (196.3)
38900 (196.3)

23. Coding Scenario
Bilateral Simple Mastectomy, Right
Breast Cancer, Left Prophylactic
Codes:
19303-RT (174.4)
LT (V50.41) (V16.3)

24. Coding Scenario Bilateral Mastectomies w/bilateral
sentinel node biopsies w/lymphatic
mapping that came back negative
Codes:
(174.2)
( 229.0)
38900 x 2 (229.0)

25. Coding Scenario
Right Needle Loc Breast Biopsy for a Breast Mass Code: RT (611.72)
A Week Later
Right Partial Mastectomy for Carcioma In-situ Code: RT ( 233.0)

26. Coding Scenario
Right Breast Cyst Aspiration x 4 w/ultrasound guidance
Codes:
19000 – RT (610.0)
19001 x 3

27. Question
And
Answer

28. the rest of your conference!
Thank You and enjoy
the rest of your conference!