Overview of CPT Code 19102: Excision of Breast Lesion
CPT Code 19102 refers to the surgical excision of a breast lesion, which may include benign or malignant tumors. This procedure is performed to remove abnormal tissue from the breast for diagnostic or therapeutic purposes.
When CPT Code 19102 is Used?
This code is applicable in various clinical scenarios.
- Presence of a palpable breast mass that requires evaluation.
- Suspicious imaging findings indicating a need for biopsy.
- Removal of benign lesions such as fibroadenomas.
- Management of breast cancer by excising malignant lesions.
Symptoms Indicating This Procedure
Patients may report several symptoms that lead to the consideration of this procedure.
- A noticeable lump or mass in the breast.
- Changes in breast shape or size.
- Nipple discharge that is bloody or clear.
- Skin changes over the breast, such as dimpling or redness.
Causes and Risk Factors
Understanding the causes and risk factors can help in early detection.
- Family history of breast cancer.
- Genetic mutations such as BRCA1 and BRCA2.
- Previous breast lesions or biopsies.
- Age, with increased risk in women over 50.
Diagnostic Tests Before Procedure
Several tests may be conducted to assess the need for excision.
- Mammography to identify abnormal areas.
- Ultrasound to evaluate the characteristics of the lesion.
- MRI for detailed imaging of breast tissue.
- Fine needle aspiration or core needle biopsy for histological analysis.
Procedure Description
The excision procedure follows a systematic approach.
- Patient is positioned comfortably and anesthesia is administered.
- An incision is made over the lesion to access the tissue.
- The lesion is carefully excised along with a margin of healthy tissue.
- The incision is closed with sutures or adhesive strips.
- Post-operative care instructions are provided.
Preparation for the Procedure
Proper preparation is essential for a successful procedure.
- Avoid blood thinners and certain medications as advised by the physician.
- Do not eat or drink for several hours before the procedure if sedation is planned.
- Arrange for transportation home post-procedure.
- Discuss any allergies or medical conditions with the healthcare provider.
Recovery and Aftercare
Recovery typically involves monitoring and care of the surgical site.
- Rest for the first 24 hours post-surgery.
- Keep the surgical site clean and dry.
- Follow-up for suture removal as directed.
- Manage pain with prescribed medications or over-the-counter pain relievers.
Possible Complications
While generally safe, there are potential risks associated with the procedure.
- Infection at the surgical site.
- Excessive bleeding or hematoma formation.
- Scarring or changes in breast appearance.
- Nerve damage leading to altered sensation.
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Post-Procedure Follow-Up
Follow-up is crucial for monitoring recovery and results.
- Schedule a follow-up appointment within 1-2 weeks post-surgery.
- Review pathology results and discuss further treatment if necessary.
- Monitor for any signs of complications during recovery.
Alternative Treatments
In some cases, non-surgical options may be considered.
- Observation for benign lesions without symptoms.
- Medications for hormonal therapy in certain breast conditions.
- Radiation therapy for localized breast cancer in select cases.
Home Care Tips
Patients can take steps to ensure a smooth recovery at home.
- Follow all post-operative care instructions provided by the surgeon.
- Avoid strenuous activities and heavy lifting for a few weeks.
- Monitor the incision site for signs of infection.
- Keep follow-up appointments to ensure proper healing.
Patient Education & Prevention
Education is key to prevention and early detection.
- Perform regular breast self-exams to detect changes early.
- Schedule routine mammograms as recommended by your healthcare provider.
- Discuss family history and risk factors with your doctor.
- Maintain a healthy lifestyle to reduce overall cancer risk.
Billing and Coding Information
CPT Code: 19102
Category: Surgery
Common Modifiers:
- 50 - Bilateral procedure
- RT - Right side
- LT - Left side
Average Cost and Insurance Coverage
Costs can vary based on several factors.
- Average cost ranges from $2,000 to $5,000 depending on facility and complexity.
- Most insurance plans cover the procedure if deemed medically necessary.
- Patients should verify coverage details with their insurance provider.
Related CPT Codes
- 19100 - 'Excision of breast lesion'
- 19101 - Biopsy of breast, percutaneous, needle
- 19103 - Excision of breast lesion, malignant
- 19200 - Excision of Breast Lesion
- 19281 - Breast Biopsy, Needle, Percutaneous
References and Sources
Frequently Asked Questions (FAQs)
What is the purpose of the excision?
The excision is performed to remove abnormal tissue for diagnosis or treatment.
Will I need anesthesia for the procedure?
Yes, local or general anesthesia will be used to ensure your comfort.
How long is the recovery period?
Most patients recover within a few weeks, but follow your doctor's advice.
Are there any risks involved?
As with any surgery, there are risks such as infection or bleeding.
When will I know the results of the biopsy?
Biopsy results are typically available within a week after the procedure.
