by David Zielske, MD, CIRCC, COC, CCVTC, CCC, CCS, RCC
Question:
According to AHA Coding Clinic 2nd Q, 2014 – Breast Codes: Biopsy and localization devices, under the Q&A section, the answer to Q #3 states both 19301 and 19283 (in my case 19281) can be coded together if performed on the same breast.
What if the marker is placed in the lumpectomy cavity, not in a different location on the same breast? Would it still be appropriate to code both procedures? There is a CCI edit and modifier is allowed, but I am thinking that that is if the lumpectomy and marker placement was done in different locations on the same breast.
Answer:
I believe CPT Assistant (May 2021) says that if the marker is placed DURING the surgery, you cannot code for the marker placement. If the marker is placed before or after the surgery, then it’s okay to code for both. In your scenario, I don’t believe you can code for both.
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