How To Use CPT Code 19112

CPT code 19112 describes the excision of a lactiferous duct fistula, which is an abnormal passage between a diseased lactiferous duct and the skin in the periareolar region. 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 19112?

CPT code 19112 is used to describe the excision of a lactiferous duct fistula. This procedure involves the removal of a tubular connection between a lactiferous duct and the skin. It is typically performed to treat a lactiferous duct fistula, which is an abnormal passage created between a diseased lactiferous duct and the skin in the periareolar region. This condition is often the result of periductal mastitis or a spontaneously draining abscess of the breast.

2. Official Description

The official description of CPT code 19112 is: ‘Excision of lactiferous duct fistula.’

3. Procedure

The excision of a lactiferous duct fistula is performed under general anesthesia. The provider begins by locating the fistula tract and making an incision around it. The skin is then elevated, and the fistula, along with the diseased lactiferous duct tissue, is excised. Bleeding points are cauterized, and the wound is irrigated with saline. The provider closes the wound with layered sutures and applies antibiotics and a dressing. In some cases, a drainage catheter may be left in place for one or two days.

4. Qualifying circumstances

CPT code 19112 is used when a patient has a lactiferous duct fistula, which is an abnormal passage between a diseased lactiferous duct and the skin in the periareolar region. This condition is typically associated with periductal mastitis or a spontaneously draining abscess of the breast. The excision of the fistula, along with the diseased lactiferous duct tissue, is the most definitive treatment option to prevent recurrence.

5. When to use CPT code 19112

CPT code 19112 should be used when a provider performs the excision of a lactiferous duct fistula. This code is appropriate when the procedure involves the complete removal of the fistula and the associated diseased lactiferous duct tissue. It is important to note that CPT code 19112 should not be used for nipple exploration without excision of a lactiferous duct.

6. Documentation requirements

To support a claim for CPT code 19112, the provider must document the following information:

• Patient’s diagnosis of a lactiferous duct fistula
• Description of the excision procedure performed
• Date of the procedure
• Details of the incision, excision, cauterization, and wound closure
• Use of antibiotics and dressing
• Any additional procedures or interventions performed
• Signature of the provider

7. Billing guidelines

When billing for CPT code 19112, ensure that the excision of a lactiferous duct fistula is performed. It is important to use the appropriate code for the specific procedure performed. There are no specific guidelines regarding reporting CPT code 19112 with other codes.

8. Historical information

CPT code 19112 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates to the code since its addition.

9. Similar codes to CPT 19112

While there are no similar codes to CPT code 19112, it is important to note that there are other codes available for related procedures. For example, CPT code 19110 is used for nipple exploration without excision of a lactiferous duct. It is important to select the appropriate code based on the specific procedure performed.

9. Examples

1. A patient presents with a lactiferous duct fistula resulting from periductal mastitis. The provider performs the excision of the fistula, removing the diseased lactiferous duct tissue.
2. A patient has a spontaneously draining abscess of the breast, which has led to the formation of a lactiferous duct fistula. The provider performs the excision of the fistula, ensuring complete removal of the abnormal passage and the associated diseased lactiferous duct tissue.
3. A lactiferous duct fistula is diagnosed in a patient who has been experiencing recurrent periductal mastitis. The provider performs the excision of the fistula, aiming to prevent further episodes of infection and drainage.
4. A patient presents with a lactiferous duct fistula following a previous abscess of the breast. The provider performs the excision of the fistula, removing the diseased lactiferous duct tissue to promote healing and prevent recurrence.
5. A lactiferous duct fistula is identified in a patient with a history of periductal mastitis. The provider performs the excision of the fistula, ensuring complete removal of the abnormal passage and the associated diseased lactiferous duct tissue.
6. A patient presents with a lactiferous duct fistula resulting from a spontaneously draining abscess of the breast. The provider performs the excision of the fistula, aiming to eliminate the abnormal passage and prevent further complications.
7. A lactiferous duct fistula is diagnosed in a patient with recurrent periductal mastitis. The provider performs the excision of the fistula, removing the diseased lactiferous duct tissue to promote healing and prevent future episodes of infection.
8. A patient presents with a lactiferous duct fistula following a previous abscess of the breast. The provider performs the excision of the fistula, ensuring complete removal of the abnormal passage and the associated diseased lactiferous duct tissue.
9. A lactiferous duct fistula is identified in a patient with a history of periductal mastitis. The provider performs the excision of the fistula, aiming to eliminate the abnormal passage and prevent further complications.
10. A patient presents with a lactiferous duct fistula resulting from a spontaneously draining abscess of the breast. The provider performs the excision of the fistula, aiming to remove the abnormal passage and promote healing.