tci Outpatient Facility Coding Alert - 2017 Issue 7

You Be the Coder: Unbundling a No-Go for Breast Procedures

Question: A new breast surgeon in our hospital outpatient department wants to bill 19301 (Mastectomy, partial (eg, lumpectomy, tylectomy, quadrantectomy, segmentectomy) along with 38525 (Biopsy or excision of lymph node(s); open, deep axillary node[s]). I think the correct coding in this scenario is 19302 (Mastectomy, partial (eg, lumpectomy, tylectomy, quadrantectomy, segmentectomy); with axillary lymphadenectomy). Which one of us is correct? Illinois Subscriber Answer: Your dilemma is common. Many surgeons — especially newer surgeons — think along the same lines, according to Christopher Chandler, MHA, MBA, CPC, CGSC, who spoke at the American Academy of Professional Coders’ 2017 Healthcon. Chandler...

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