Overview of CPT Code 17499: Unlisted Procedure, Breast

Overview of CPT Code 17499: Unlisted Procedure, Breast

CPT Code 17499 refers to an unlisted procedure for the breast, used when a specific procedure does not have a designated code. This code is often utilized in cases where unique surgical interventions are required for breast conditions.

When CPT Code 17499 is Used?

This code is appropriate in various clinical scenarios, including:

• Surgical intervention for rare breast tumors not covered by existing codes.
• Innovative techniques for breast reconstruction not classified under standard codes.
• Experimental procedures for breast conditions in clinical trials.

Symptoms Indicating This Procedure

Patients may report the following symptoms that could lead to the use of this code:

• Unusual lumps or masses in the breast.
• Persistent pain or discomfort in the breast area.
• Changes in breast shape or size.
• Skin changes over the breast, such as redness or swelling.

Causes and Risk Factors

Several factors may contribute to the need for an unlisted breast procedure:

• Genetic predisposition to breast cancer.
• Previous breast surgeries or radiation therapy.
• Hormonal imbalances affecting breast tissue.
• Family history of breast diseases.

Diagnostic Tests Before Procedure

Prior to the procedure, the following diagnostic tests may be conducted:

• Mammography to identify abnormalities.
• Ultrasound imaging for further evaluation of breast masses.
• MRI for detailed imaging of breast tissue.
• Biopsy to determine the nature of a lump.

Procedure Description

The procedure may vary based on the specific intervention but generally includes the following steps:

• Patient is positioned comfortably and anesthetized.
• Incision is made at the designated site on the breast.
• Surgical intervention is performed based on the specific condition.
• Incision is closed with sutures or adhesive strips.
• Post-operative care instructions are provided.

Preparation for the Procedure

Patients should follow these steps to prepare for the procedure:

• Avoid eating or drinking after midnight before the procedure.
• Discuss all medications with the healthcare provider.
• Arrange for transportation to and from the facility.
• Wear loose, comfortable clothing on the day of the procedure.

Recovery and Aftercare

Post-procedure recovery typically involves:

• Resting for at least 24 hours after the procedure.
• Keeping the surgical site clean and dry.
• Taking prescribed pain medications as needed.
• Monitoring for signs of infection, such as increased redness or discharge.

Possible Complications

As with any surgical procedure, there are potential risks, including:

• Infection at the surgical site.
• Excessive bleeding or hematoma formation.
• Scarring or changes in breast appearance.
• Anesthesia-related complications.

Secure, compliant, and built for trust

HIPAA-compliant and designed with privacy in mind, your patient’s data is protected. Focus on care while we safeguard your information.

Learn more

Post-Procedure Follow-Up

Follow-up appointments are crucial for monitoring recovery:

• Initial follow-up within one week post-procedure.
• Subsequent visits as directed by the healthcare provider.
• Regular breast examinations as part of ongoing care.

Alternative Treatments

Patients may consider these non-surgical options:

• Medication management for hormonal imbalances.
• Physical therapy for pain relief.
• Regular monitoring and imaging for benign conditions.

Home Care Tips

To aid recovery, patients should consider the following:

• Apply ice packs to reduce swelling.
• Avoid strenuous activities for a few weeks.
• Follow a balanced diet to support healing.
• Stay hydrated and rest adequately.

Patient Education & Prevention

To prevent recurrence, patients should focus on:

• Regular breast self-exams to detect changes early.
• Routine mammograms as recommended by healthcare providers.
• Healthy lifestyle choices, including diet and exercise.
• Genetic counseling if there is a family history of breast cancer.

Billing and Coding Information

CPT Code: 17499

Category: Surgery

Common Modifiers:

• 22 - Increased Procedural Services
• 50 - Bilateral Procedure

Average Cost and Insurance Coverage

Costs for this procedure can vary widely:

• Average costs range from $2,000 to $10,000 depending on complexity.
• Insurance coverage may vary; pre-authorization is often required.
• Patients should check with their insurance provider for specific benefits.

Related CPT Codes

• 19301 - Breast Reconstruction, Unilateral
• 19302 - Breast Reconstruction with Implant
• 19303 - Breast Reconstruction with Implant
• 19304 - Breast Reconstruction with Implant
• 19305 - Breast Reconstruction with Implant

References and Sources

• American College of Surgeons
• National Cancer Institute
• American Society of Clinical Oncology