How To Use CPT Code 3374F

CPT 3374F refers to the documentation of AJCC Breast Cancer Stage I, specifically subclassification T1c, which indicates a tumor size greater than 1 cm but less than or equal to 2 cm. This code is utilized by healthcare providers to accurately classify and record the stage of breast cancer in female patients aged 18 years or older. The classification is crucial for determining the appropriate treatment plan and monitoring the patient’s response to therapy.

1. What is CPT code 3374F?

CPT code 3374F is a specific code used to document the classification of breast cancer according to the American Joint Committee on Cancer (AJCC) staging system. This code is particularly relevant for female patients aged 18 years and older who have been diagnosed with breast cancer classified as stage I, with a subclassification of T1c. The T1c designation indicates that the tumor size is greater than 1 cm but less than or equal to 2 cm in its greatest dimension. The AJCC staging system is an essential tool in oncology, as it helps healthcare providers communicate the extent of cancer, plan treatment strategies, and predict patient outcomes. Accurate staging is critical for determining the most effective treatment options, including the use of hormone therapies such as tamoxifen and aromatase inhibitors, which are prescribed for estrogen or progesterone receptor-positive tumors.

2. Qualifying Circumstances

This CPT code can be used when a female patient, aged 18 years or older, is diagnosed with breast cancer classified as stage I, specifically T1c. The criteria for using this code include the documentation of tumor size, which must be greater than 1 cm but less than or equal to 2 cm. It is important to note that this code is appropriate for patients who have tumors that are either estrogen receptor-positive (ER+) or progesterone receptor-positive (PR+), and who are prescribed hormone therapies such as tamoxifen or aromatase inhibitors. Inappropriate use of this code would occur if the tumor size does not meet the specified criteria or if the patient does not have a confirmed diagnosis of breast cancer.

3. When To Use CPT 3374F

CPT code 3374F should be used when documenting the stage of breast cancer in eligible female patients. The provider must ensure that the documentation includes the tumor size and the date of measurement. This code can be reported at least once within a year for patients who meet the criteria of having progesterone or estrogen receptor-positive tumors and are undergoing treatment with tamoxifen or aromatase inhibitors. It is essential to avoid using this code in conjunction with codes that represent different stages of breast cancer or when the tumor size does not fall within the T1c classification.

4. Official Description of CPT 3374F

Official Descriptor: AJCC Breast Cancer Stage I: T1c (tumor size > 1 cm to 2 cm) documented (ONC)

5. Clinical Application

CPT code 3374F is applied in the clinical context of diagnosing and managing breast cancer in female patients. The accurate documentation of the cancer stage is vital for treatment planning and monitoring patient progress. The classification of breast cancer into stages helps healthcare providers determine the most appropriate interventions, including surgical options, radiation therapy, and systemic treatments such as hormone therapy. The use of this code ensures that the patient’s medical record reflects the current status of their cancer, which is essential for ongoing care and treatment adjustments.

5.1 Provider Responsibilities

The provider’s responsibilities during the application of this code include accurately assessing the tumor size through imaging studies or physical examination, confirming the diagnosis of breast cancer, and documenting the findings in the patient’s healthcare record. The provider must also ensure that the patient meets the age criteria and that the tumor is classified as T1c. Additionally, the provider should discuss treatment options with the patient, including the use of hormone therapies, and document the date of measurement and any relevant clinical decisions made regarding the patient’s care.

5.2 Unique Challenges

One of the unique challenges associated with the use of CPT code 3374F is ensuring accurate measurement of tumor size, as discrepancies can lead to misclassification of the cancer stage. Providers must be diligent in their assessments and may need to rely on imaging studies for precise measurements. Furthermore, the documentation process requires careful attention to detail to ensure compliance with coding guidelines and to facilitate effective communication among healthcare providers involved in the patient’s care. Additionally, managing patient expectations and understanding the implications of the cancer stage on treatment options can also pose challenges.

5.3 Pre-Procedure Preparations

Before applying CPT code 3374F, the provider must conduct a thorough evaluation of the patient, which may include imaging studies such as mammograms or ultrasounds to assess tumor size. A biopsy may also be performed to confirm the diagnosis of breast cancer and to evaluate hormone receptor status. The provider should review the patient’s medical history, including any previous treatments or surgeries, and discuss the diagnosis and staging with the patient to ensure they understand the implications for their treatment plan.

5.4 Post-Procedure Considerations

After documenting the use of CPT code 3374F, the provider must continue to monitor the patient for any changes in their condition. This includes regular follow-up appointments to assess the effectiveness of prescribed treatments, such as hormone therapy, and to evaluate for any potential side effects. The provider should also ensure that the patient’s healthcare record is updated with any new findings or changes in treatment plans, and that the patient is informed about their ongoing care and any necessary lifestyle modifications.

6. Relevant Terminology

AJCC: The American Joint Committee on Cancer, an organization that provides a standardized system for cancer staging.

Stage I Breast Cancer: An early stage of breast cancer where the tumor is small and localized, with no evidence of lymph node involvement or distant metastasis.

T1c: A subclassification of stage I breast cancer indicating a tumor size greater than 1 cm but less than or equal to 2 cm.

Estrogen Receptor Positive (ER+): A classification indicating that breast cancer cells have receptors for estrogen, which can promote cancer growth.

Progesterone Receptor Positive (PR+): A classification indicating that breast cancer cells have receptors for progesterone, which can also promote cancer growth.

Tamoxifen: A medication used to treat hormone receptor-positive breast cancer by blocking estrogen’s effects on breast tissue.

Aromatase Inhibitors: A class of drugs that reduce estrogen levels in the body, used to treat hormone receptor-positive breast cancer.

7. Clinical Examples

1. A 45-year-old female patient is diagnosed with breast cancer after a routine mammogram reveals a tumor measuring 1.5 cm. The provider documents the tumor as T1c and prescribes tamoxifen.

2. A 60-year-old woman presents with a palpable breast mass that is confirmed to be 1.8 cm in size. The oncologist stages her cancer as T1c and discusses treatment options.

3. A patient undergoing treatment for breast cancer has her tumor size measured at 2 cm during a follow-up visit. The provider updates her records to reflect the T1c classification.

4. A 50-year-old female with a history of breast cancer has a new tumor identified at 1.2 cm. The provider documents this as T1c and recommends hormone therapy.

5. A patient with a newly diagnosed breast tumor measuring 1.7 cm is classified as T1c, and the provider discusses the implications of this staging with her.

6. A 38-year-old woman diagnosed with breast cancer has a tumor size of 1.9 cm. The provider documents this as T1c and initiates treatment with an aromatase inhibitor.

7. A patient with a confirmed diagnosis of breast cancer has her tumor size measured at 1.3 cm. The provider records this as T1c and schedules her for further evaluation.

8. A 70-year-old female patient presents with a tumor size of 1.4 cm. The oncologist documents the cancer stage as T1c and discusses the treatment plan.

9. A patient with a breast tumor measuring 1.6 cm is classified as T1c, and the provider prescribes tamoxifen as part of her treatment regimen.

10. A 55-year-old woman is diagnosed with breast cancer, and her tumor size is recorded at 1.1 cm. The provider documents this as T1c and discusses the importance of hormone receptor testing.