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AHA Coding Clinic® for HCPCS - 2021 Issue 3; Ask the Editor

Excision of benign breast mass

A patient with discomfort from bilateral breast masses presented for removal via excisional breast biopsies. The lesion in the right breast was identified with the use of ultrasound and an incision was made in a curvilinear fashion. The area of concern was widely excised along with normal breast tissue in an attempt to achieve clear margins. The specimen was sent to pathology for examination. In order to close the large defect created by the excision of the lesion, advancement flaps were utilized by creating rotational pedicle flaps with the surrounding breast tissue to fill the defect. The same procedure was repeated on the left breast.What is the correct CPT code for excision of a benign breast mass? CPT code 19120 does not include the attention to margins that are detailed in the operative note and CPT code 19301 is reported for treatment or prevention of breast cancer. ...

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