Coding Breast Procedures - AAPC Virginia Coding Conference 2013

Report
Coding Breast Procedures
Lynn Pegram, CPC, CPC-I, CGSC, CEMC
Mid-Atlantic Coding, LLC
www.codingpros.net
[email protected]
804-474-3325
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.
BREAST
PROCEDURES
Non-Invasive Breast Procedure
Mammotome Breast Biopsy
PROCEDURE: MAMMOTOME BREAST BIOPSY
Pre-op Dx: Mass, right breast
Post-op Dx: Mass, right breast
Surgeon: Dr Addison
Montgomery
Anesthesia: Local
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)
Coding Scenario
Left Simple mastectomy with
inraoperative lymphatic mapping
and left axillary sentinel node
dissection.
Codes: 19303-LT (174.4)
38525-LT (229.0)
38900 (229.0)
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.
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)
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)
Coding Scenario
Bilateral Simple Mastectomy, Right
Breast Cancer, Left Prophylactic
Codes:
19303-RT (174.4)
19303-59LT (V50.41) (V16.3)
Coding Scenario
Bilateral Mastectomies w/bilateral
sentinel node biopsies w/lymphatic
mapping that came back negative
Codes:
19303-50 (174.2)
38525-50 ( 229.0)
38900 x 2 (229.0)
Coding Scenario
Right Needle Loc Breast Biopsy for a
Breast Mass Code: 19125-RT (611.72)
A Week Later
Right Partial Mastectomy for Carcioma Insitu Code: 19301-58RT ( 233.0)
Coding Scenario
Right Breast Cyst Aspiration x 4
w/ultrasound guidance
Codes:
19000 – RT (610.0)
19001 x 3
76942-26
Question
And
Answer
Thank You and enjoy
the rest of your conference!

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