CPT 19301 describes a partial mastectomy procedure involving removing suspicious or cancerous lesions in the breast through an incision in the skin.
What Is CPT Code 19301?
CPT code 19301 describes a partial mastectomy procedure, which involves removing suspicious or cancerous lesions in the breast through an incision in the skin.
This may include a lumpectomy, tylectomy, segmental mastectomy, quadrantectomy, or the removal of a significant portion of the breast along with any additional lesions in the area.
The provider will place a drain, close the incision, and apply a dressing after the surgery.
The CPT book describes CPT code 19301 as: “Mastectomy, partial (e.g., lumpectomy, tylectomy, quadrantectomy, segmentectomy).”
The provider incises the skin of the breast over a suspicious lump and excises the lump or a significant portion of the breast along with the margins. Any additional lesions in the area are checked and also removed.
When all cancerous or suspicious tissues are eradicated, he places a drain, closes the surgical wound, and applies a dressing.
A partial mastectomy applies to a segmental mastectomy, quadrantectomy, lumpectomy, or tylectomy.
In segmental mastectomy and quadrantectomy, the surgeon removes more breast tissue than with a lumpectomy or tylectomy.
Lumpectomy and tylectomy involve the removal of a tumor along with surrounding margins. A partial mastectomy is performed to eradicate suspicious or cancerous lesions in the breast through an open and excisional process.
How To Use CPT 19301
Do not bill CPT 19301 if the procedure was performed with the excision of axillary lymph nodes. You can use CPT 19302 instead.
If a surgeon removes a lesion and a significant amount of surrounding tissue, it may be appropriate to report a partial mastectomy code rather than a lesion excision code.
To do this, documentation should show that sufficient margins were removed. This can increase revenue for the provider.
If a partial mastectomy (CPT code 19301) is followed by a return visit from the surgeon during the recovery period to check for lymph node involvement, the surgeon may choose to remove the nodes at that time.
This would be considered a staged procedure and should be reported using CPT code 38745 with modifier 58.