CPT code 19302 is a medical billing code for a partial mastectomy with lymph node removal, used to streamline healthcare billing and documentation.
CPT code 19302 is a medical billing code used to describe a partial mastectomy procedure that includes the removal of lymph nodes. This code is typically used when a surgeon removes part of the breast tissue along with some of the nearby lymph nodes to treat or prevent the spread of breast cancer. The procedure aims to excise the cancerous tissue while preserving as much of the healthy breast tissue as possible.
For CPT code 19302, the following modifiers may be applicable:
1. Modifier 50 - Bilateral Procedure: Used when the procedure is performed on both sides of the body during the same operative session.
2. Modifier 51 - Multiple Procedures: Applied when multiple procedures are performed during the same surgical session.
3. Modifier 59 - Distinct Procedural Service: Indicates that a procedure or service was distinct or independent from other services performed on the same day.
4. Modifier 62 - Two Surgeons: Used when two surgeons work together as primary surgeons performing distinct parts of a single reportable procedure.
5. Modifier 66 - Surgical Team: Applied when a team of surgeons is required to perform the procedure.
6. Modifier 76 - Repeat Procedure by Same Physician: Used when the same physician performs a procedure or service more than once on the same day.
7. Modifier 77 - Repeat Procedure by Another Physician: Applied when a procedure or service is repeated by another physician on the same day.
8. Modifier 78 - Unplanned Return to the Operating/Procedure Room by the Same Physician Following Initial Procedure for a Related Procedure During the Postoperative Period: Indicates a return to the operating room for a related procedure during the postoperative period.
9. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period: Used when a procedure or service performed during the postoperative period is unrelated to the original procedure.
10. Modifier 80 - Assistant Surgeon: Applied when an assistant surgeon is required during the procedure.
11. Modifier 81 - Minimum Assistant Surgeon: Used when a minimum assistant surgeon is required during the procedure.
12. Modifier 82 - Assistant Surgeon (when qualified resident surgeon not available): Applied when an assistant surgeon is required and a qualified resident surgeon is not available.
13. Modifier AS - Physician Assistant, Nurse Practitioner, or Clinical Nurse Specialist Services for Assistant at Surgery: Used when these non-physician practitioners assist in surgery.
Each of these modifiers serves a specific purpose and should be used appropriately to ensure accurate billing and reimbursement.
The CPT code 19302, which involves a specific medical procedure, is reimbursed by Medicare. To determine the reimbursement rate, healthcare providers should refer to the Medicare Physician Fee Schedule (MPFS), which outlines the payment rates for services covered under Medicare Part B.
Additionally, it is essential to consult with the respective Medicare Administrative Contractor (MAC) for your region, as they provide guidance on coverage policies and any local variations in reimbursement. The MACs are responsible for processing Medicare claims and can offer detailed information on the specific requirements and documentation needed for the CPT code 19302.
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