How To Use CPT Code 19300

CPT code 19300 describes the surgical procedure known as mastectomy for gynecomastia. 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 19300?

CPT 19300 is a code used to describe the surgical removal of one or both breasts or part of the breast in male patients to treat excessive enlargement of the male breast, a condition known as gynecomastia. This procedure is performed by a physician and involves the excision of excess skin, fat, and breast tissue from the pectoralis muscle fascia.

2. Official Description

The official description of CPT code 19300 is: ‘Mastectomy for gynecomastia.’

3. Procedure

The surgical procedure for CPT 19300 involves the following steps:

1. The patient is taken to the operating room and positioned supine.
2. The operative site is cleansed and sterilized.
3. General anesthesia is administered to the patient.
4. An infraareolar incision is made at the rims of the areola.
5. The physician cuts around the nipple and areola to remove excess skin.
6. Excessive skin, fat, and breast tissue are removed from the pectoralis muscle fascia in a specific pattern.
7. A vacuum procedure may be used to remove excess fat.
8. Bleeding is controlled using electrocautery.
9. The incision is closed with fine stitches.
10. A drainage tube may be placed through a separate incision to drain any fluid substance.
11. The wound is dressed with a surgical bandage.

4. Qualifying circumstances

CPT 19300 is performed only on male patients to treat gynecomastia, which is characterized by the excessive growth of the male mammary glands. It should never be reported for a female patient. The procedure involves the excision of breast tissue due to an imbalance of sex hormones.

5. When to use CPT code 19300

CPT code 19300 should be used when a physician performs a mastectomy for gynecomastia in a male patient. It should not be used for breast tissue removal for breast-size reduction for reasons other than gynecomastia, for which CPT code 19318 should be used instead.

6. Documentation requirements

To support a claim for CPT 19300, the physician must document the following information:

• Patient’s gender
• Diagnosis of gynecomastia
• Description of the surgical procedure performed
• Date of the procedure
• Start and end time of the procedure
• Details of any additional procedures performed, such as the use of a vacuum procedure or placement of drainage tubes
• Any complications or unexpected findings
• Signature of the performing physician

7. Billing guidelines

When billing for CPT 19300, ensure that the procedure is performed on a male patient for the treatment of gynecomastia. It should not be reported for female patients or for breast-size reduction for reasons other than gynecomastia. There are no specific guidelines regarding reporting CPT 19300 with other codes.

8. Historical information

CPT 19300 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 19300

There are no similar codes to CPT 19300.

9. Examples

1. A 35-year-old male patient undergoes a mastectomy for gynecomastia to treat excessive enlargement of his breasts.
2. A 42-year-old male patient with gynecomastia undergoes a mastectomy to remove excess breast tissue and achieve a more masculine chest appearance.
3. A 28-year-old male patient with gynecomastia undergoes a mastectomy to alleviate discomfort and improve his self-confidence.
4. A 50-year-old male patient with gynecomastia undergoes a mastectomy to address the psychological and physical effects of excessive breast growth.
5. A 19-year-old male patient with gynecomastia undergoes a mastectomy to improve his body image and quality of life.
6. A 60-year-old male patient with gynecomastia undergoes a mastectomy to alleviate pain and discomfort caused by the excessive growth of his breasts.
7. A 45-year-old male patient with gynecomastia undergoes a mastectomy to restore a more masculine chest contour and improve his self-esteem.
8. A 32-year-old male patient with gynecomastia undergoes a mastectomy to address the social and psychological impact of his condition.
9. A 55-year-old male patient with gynecomastia undergoes a mastectomy to reduce the size of his breasts and improve his overall appearance.
10. A 25-year-old male patient with gynecomastia undergoes a mastectomy to correct the hormonal imbalance causing the excessive growth of his breasts.