How To Use CPT Code 19105

CPT 19105 describes the cryosurgical ablation of a fibroadenoma, a noncancerous breast tumor, using a cryoprobe and ultrasound guidance. 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 19105?

CPT 19105 is used to describe the cryosurgical ablation of a fibroadenoma, which is a solid, noncancerous tumor in the breast. This procedure involves the use of a cryoprobe, which is inserted through a small incision in the breast, and ultrasound guidance to precisely target and destroy the fibroadenoma cells using extreme cold.

2. Official Description

The official description of CPT code 19105 is: ‘Ablation, cryosurgical, of fibroadenoma, including ultrasound guidance, each fibroadenoma.’

3. Procedure

During the cryosurgical ablation of a fibroadenoma, the healthcare provider first preps and anesthetizes the patient. Then, using ultrasound guidance, the provider inserts a cryoprobe through a small incision in the breast and positions it directly on the fibroadenoma. The cryoprobe contains liquid nitrogen, which forms ice balls to freeze and destroy the fibroadenoma cells. Over time, the body’s immune system absorbs the dead tissues.

4. Qualifying circumstances

CPT 19105 is used for the cryosurgical ablation of fibroadenomas, which are solid, noncancerous breast tumors. These tumors are usually painless and do not increase the risk of breast cancer. The procedure is performed on patients who have been diagnosed with fibroadenomas and require treatment to remove or reduce the size of the tumor. The use of ultrasound guidance is also a qualifying circumstance for this code.

5. When to use CPT code 19105

CPT code 19105 should be used when a healthcare provider performs cryosurgical ablation on a fibroadenoma using a cryoprobe and ultrasound guidance. It is important to note that code 19105 should not be reported in conjunction with codes 76940 or 76942, as the description of 19105 already includes ultrasound guidance.

6. Documentation requirements

To support a claim for CPT 19105, the healthcare provider must document the following information:

• Patient’s diagnosis of fibroadenoma
• Use of ultrasound guidance during the procedure
• Date of the procedure
• Start and end time of the procedure
• Details of the procedure, including the use of a cryoprobe and the freezing of the fibroadenoma cells
• Any complications or additional procedures performed
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 19105, ensure that the procedure involves the cryosurgical ablation of a fibroadenoma using a cryoprobe and ultrasound guidance. Do not report code 19105 with codes 76940 or 76942. It is important to note that cryoablation of malignant breast tumors should be reported using code 0581T. Additionally, if multiple fibroadenomas are treated with one cryoprobe insertion, code 19105 should only be reported once.

8. Historical information

CPT 19105 was added to the Current Procedural Terminology system on January 1, 2007. There have been no updates to the code since its addition.

9. Similar codes to CPT 19105

There are several similar codes to CPT 19105 that are used for different procedures. These include:

• CPT 19106: Ablation, cryosurgical, of breast tumor(s), including ultrasound guidance, each tumor
• CPT 19107: Ablation, cryosurgical, of breast tumor(s), including ultrasound guidance, first tumor
• CPT 19120: Excision of cyst, fibroadenoma, or other benign or malignant tumor, aberrant breast tissue, duct lesion, nipple or areolar lesion (except 19300), open, male or female, one or more lesions
• CPT 19125: Excision of breast duct lesion identified on preoperative imaging, open, male or female, one or more lesions
• CPT 19126: Excision of breast duct lesion identified on preoperative imaging, percutaneous, needle core, using imaging guidance

9. Examples

1. A healthcare provider performs cryosurgical ablation on a fibroadenoma in the left breast of a female patient using a cryoprobe and ultrasound guidance.
2. A patient with multiple fibroadenomas undergoes cryosurgical ablation using a cryoprobe and ultrasound guidance. The provider treats each fibroadenoma individually.
3. A healthcare provider performs cryosurgical ablation on a fibroadenoma in the right breast of a male patient using a cryoprobe and ultrasound guidance.
4. A female patient with a large fibroadenoma undergoes cryosurgical ablation using a cryoprobe and ultrasound guidance to reduce the size of the tumor.
5. A healthcare provider performs cryosurgical ablation on a fibroadenoma in the left breast of a pregnant patient using a cryoprobe and ultrasound guidance.
6. A patient with a fibroadenoma in the right breast undergoes cryosurgical ablation using a cryoprobe and ultrasound guidance. The procedure is performed as an outpatient.
7. A healthcare provider performs cryosurgical ablation on a fibroadenoma in the left breast of an elderly patient using a cryoprobe and ultrasound guidance.
8. A female patient with a fibroadenoma in the right breast undergoes cryosurgical ablation using a cryoprobe and ultrasound guidance. The procedure is performed under local anesthesia.
9. A healthcare provider performs cryosurgical ablation on a fibroadenoma in the left breast of a young adult patient using a cryoprobe and ultrasound guidance.
10. A patient with a fibroadenoma in the right breast undergoes cryosurgical ablation using a cryoprobe and ultrasound guidance. The procedure is performed in a hospital setting.