AMA CPT® Assistant - 2016 Issue 6 (June)
Soft Tissue Localization (10035, 10036) (June 2016)
June 2016 page 3 Soft Tissue Localization (10035, 10036) Medical advances in the treatment of cancer have increased the importance of marking lesions to identify their locations prior to therapy (eg, neoadjuvant chemotherapy). Frequently, a lesion may no longer be visible or palpable after therapy; therefore, marking a lesion prior to therapy enables the area to be found for subsequent surgical excision. Although Current Procedural Terminology (CPT®) codes exist for reporting of marker placement(s) into various organs (eg, prostate, breast), prior to 2016 there were no specific codes to report marker placement into soft tissue, such as into...
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Article Overview
This June 2016 CPT Assistant article reviews the introduction of soft tissue localization codes in the 2016 CPT code set and discusses the broader context for lesion marking before therapy. It is aimed at coders, billers, and other professionals who need to understand when these CPT codes fit versus when other site-specific CPT services or imaging guidance codes may be relevant.
Why This Topic Matters
Soft tissue localization became a distinct reportable service in CPT, affecting how lesion marking is captured for surgical planning and cancer-related care. The article helps readers recognize the general scope of the service and the surrounding CPT framework without relying on unlisted code reporting.
Article Sections
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Soft Tissue Localization
Introduces the topic of lesion marking in soft tissue and summarizes why the service became important in cancer care and other settings. It also places the discussion within the 2016 CPT code set.
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Coding Tip
Provides general CPT guidance about reporting considerations when soft tissue localization is performed alongside other site-based services. It also notes that some sites have their own CPT options.
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Clinical Example (10035) / Description of Procedure (10035)
Presents an illustrative scenario and a corresponding procedural narrative for the first soft tissue lesion example. The material shows the clinical context and workflow at a high level.
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Clinical Example (10036) / Description of Procedure (10036)
Presents an illustrative scenario and a corresponding procedural narrative for an additional lesion example. The material shows the clinical context and workflow at a high level.
What You Will Learn
- The general purpose of soft tissue localization in pre-therapy care
- How the 2016 CPT code set introduced this service category
- How the article situates soft tissue localization among other CPT options
- The types of clinical scenarios used to illustrate reporting
- The role of imaging guidance in this service category
Who Should Read This
- Medical coders
- Coding auditors
- Billing professionals
- Physician practices
- Hospital outpatient coding staff
- Oncology practice administrators
Codes Discussed
Code Ranges Discussed
Modifiers Discussed
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