tci General Surgery Coding Alert - 1999 Issue 5

Amount of Tissue Removal Determines Whether Partial Mastectomy Can Be Billed

The amount of tissue removednot the intent of the surgeon when the procedure beganis the key to determining whether a partial mastectomy was performed, says Georgeann Edford, RN, MBA, who heads Coding Compliance Solutions, a medical reimbursement firm in Birmingham, MI. Knowing precisely where a lumpectomy ends and a partial mastectomy begins may be confusing because the usual references are vague on the issue. For example, CPT 1999 offers a short, cut-and-dry descriptor for code 19160mastectomy, partial. No further parameters are given for the code, or how it is distinguished from related codes such as 19120 (excision of cyst...

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