Reader Questions: Beware Breast-Plus-Lymph Pitfall

Why This Topic Matters

Breast surgery cases can be coded incorrectly when the extent of the breast procedure and associated lymph node work are not matched to the most specific CPT code. This article matters because it highlights a common coding pitfall and references an NCCI bundle that can affect claim reporting.

Article Sections

1. Question

   Presents the coding scenario and the question posed by the subscriber about reporting the breast and axillary procedures.

2. Answer

   Explains the recommended CPT approach for the described operative service and discusses why other reporting options are not appropriate.

3. NCCI

   Notes the National Correct Coding Initiative relationship relevant to the procedures discussed in the article.

4. Avoid

   Identifies an additional CPT option discussed in the context of why it does not fit the documented service.