How To Use CPT Code 19030

CPT code 19030 describes the injection procedure for a mammary ductogram or galactogram, which is used to visualize the milk ducts of the breast. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 19030?

CPT 19030 is used to report the injection procedure for a mammary ductogram or galactogram. This procedure involves the injection of a contrast agent into the breast to visualize the milk ducts. It is typically performed to diagnose disorders of the milk ducts, such as clear or bloody discharge from the nipples. The contrast is injected through a small catheter, and mammographic images are taken to evaluate the ducts.

2. Official Description

The official description of CPT code 19030 is: ‘Injection procedure only for mammary ductogram or galactogram (For radiological supervision and interpretation, see 77053, 77054)’

3. Procedure

The procedure for CPT 19030 involves several steps:

1. The patient is positioned in a sitting or supine position.
2. The healthcare provider identifies the duct responsible for the abnormal discharge by manually expressing fluid through the nipple.
3. A small catheter is inserted into the milk duct.
4. A contrast agent is injected through the catheter into the milk duct.
5. Mammographic images are taken to visualize the milk ducts.

4. Qualifying circumstances

CPT 19030 is used for patients who require a mammary ductogram or galactogram to evaluate the milk ducts of the breast. This procedure is typically performed when a patient presents with abnormal discharge from the nipples. It is important to note that CPT 19030 is only for the injection procedure and does not include radiological supervision and interpretation, which should be reported separately using CPT codes 77053 and 77054.

5. When to use CPT code 19030

CPT code 19030 should be used when a healthcare provider performs the injection procedure for a mammary ductogram or galactogram. It is important to note that this code should only be reported for the injection and not for the radiological supervision and interpretation. If both the injection and the radiological supervision and interpretation are performed, the appropriate CPT codes should be used to report each component separately.

6. Documentation requirements

To support a claim for CPT 19030, the healthcare provider must document the following information:

• Patient’s symptoms or indication for the procedure
• Details of the injection procedure, including the use of a contrast agent and the insertion of a catheter
• Date and time of the procedure
• Any additional relevant information, such as the number of ducts injected or any complications encountered
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 19030, it is important to ensure that the procedure performed is solely the injection for the mammary ductogram or galactogram. The radiological supervision and interpretation should be reported separately using the appropriate CPT codes (77053, 77054). It is also important to follow any specific billing guidelines provided by the payer or Medicare to ensure accurate reimbursement.

8. Historical information

CPT 19030 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates or changes to the code since its addition.

9. Similar codes to CPT 19030

There are no similar codes to CPT 19030 for the injection procedure of a mammary ductogram or galactogram.

9. Examples

1. A healthcare provider performs the injection procedure for a mammary ductogram to evaluate a patient with clear discharge from the nipples.
2. A patient presents with bloody discharge from the nipples, and a healthcare provider performs the injection procedure for a galactogram to visualize the milk ducts.
3. A healthcare provider performs the injection procedure for a mammary ductogram to investigate a patient’s breast abnormalities.
4. A patient with recurrent nipple discharge undergoes the injection procedure for a galactogram to assess the milk ducts.
5. A healthcare provider performs the injection procedure for a mammary ductogram to evaluate a patient with suspected ductal carcinoma in situ.
6. A patient with persistent nipple discharge undergoes the injection procedure for a galactogram to rule out any abnormalities in the milk ducts.
7. A healthcare provider performs the injection procedure for a mammary ductogram to investigate a patient’s breast pain and discharge.
8. A patient with a history of breast cancer undergoes the injection procedure for a galactogram to assess the milk ducts for any recurrence or new abnormalities.
9. A healthcare provider performs the injection procedure for a mammary ductogram to evaluate a patient with recurrent mastitis.
10. A patient with a breast lump and abnormal discharge undergoes the injection procedure for a galactogram to assess the milk ducts and aid in diagnosis.