![]() This column responds to some frequently asked coding questions related to breast cancer operations, sentinel node biopsy, ultrasound-guided core biopsies, excision with wires, intraoperative assessment of margins, and more. Consequently, the American College of Surgeons (ACS) General Surgery Coding and Reimbursement Committee (GSCRC) often receives questions about coding, particularly for breast surgery. How do you code for ablation of breast lesions with cryotherapy, microwave, RFA, or laser?Ĭoding for surgical services can be complicated due to the numerous rules, guidelines, and exceptions-all of which the Centers for Medicare & Medicaid Services frequently updates and revises.How do you code for intraoperative radiation or placement of the different devices for brachytherapy?.How should I code for nipple-sparing mastectomy and skin-sparing mastectomy to distinguish them from total mastectomy?.How would I code for intraoperative assessment of margins, for instance, with radiofrequency spectroscopy?.Could I code for the X ray of the operative specimen with CPT code 76098?. ![]() How do you code re-excision of a lumpectomy cavity when you must return for positive margins on final pathology a week after a lumpectomy?.How do you code for excision of additional tissue for margins at the time of lumpectomy? Is there a code for the added work of orienting and inking margins?.Do you code differently for excision with multiple wires for localization than with one wire?.I perform ultrasound-guided core biopsies but do not leave localization devices in the biopsy location.Can I code for injection of radioactive tracer and blue dye for sentinel lymph node biopsy?.Can I use multiple codes for this procedure? ![]() When a total mastectomy with sentinel node biopsy is performed, I obtain a frozen section of the nodes and proceed to dissect the axilla if positive. ![]()
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