Overview of CPT Code 19120: Excision of Breast Lesion
CPT Code 19120 refers to the surgical excision of a breast lesion, which may include tumors or abnormal growths. This procedure is performed to remove suspicious or problematic tissue for diagnostic and therapeutic purposes.
When CPT Code 19120 is Used?
This procedure is indicated in various clinical scenarios.
- Presence of a palpable breast mass that requires evaluation.
- Suspicious findings on imaging studies such as mammograms.
- Biopsy results indicating atypical or malignant cells.
- Patient history of breast cancer necessitating removal of lesions.
Symptoms Indicating This Procedure
Patients may report several symptoms that lead to the consideration of this procedure.
- A lump or mass in the breast that can be felt.
- 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 or BRCA2.
- Previous breast lesions or biopsies.
- Age, with increased risk in women over 50.
Diagnostic Tests Before Procedure
Several tests may be conducted to guide the decision for excision.
- Mammography to identify abnormalities.
- Ultrasound to assess the characteristics of the lesion.
- MRI for detailed imaging of breast tissue.
- Fine needle aspiration or core needle biopsy for histological evaluation.
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 appointments to monitor healing.
- Pain management with prescribed medications as needed.
Possible Complications
While generally safe, there are potential risks associated with the procedure.
- Infection at the surgical site.
- 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 care is crucial for monitoring recovery.
- Initial follow-up within one week to check the incision.
- Further follow-ups based on pathology results.
- Regular breast examinations as recommended by the physician.
Alternative Treatments
In some cases, non-surgical options may be considered.
- Monitoring with regular imaging if the lesion is benign.
- Medications for hormonal therapy in specific cases.
- Radiation therapy for certain types of breast lesions.
Home Care Tips
Patients can take steps to aid their recovery at home.
- Avoid strenuous activities for a few weeks.
- Use ice packs to reduce swelling.
- Follow dietary recommendations for healing.
- Keep follow-up appointments and report any concerns.
Patient Education & Prevention
Education is key to prevention and early detection.
- Regular breast self-exams to detect changes early.
- Annual mammograms as recommended based on age and risk factors.
- Healthy lifestyle choices to reduce breast cancer risk.
- Genetic counseling for those with a family history of breast cancer.
Billing and Coding Information
CPT Code: 19120
Category: Surgical Procedures
Common Modifiers:
- 50 - Bilateral procedure
- RT - Right side
- LT - Left side
Average Cost and Insurance Coverage
Costs can vary based on location and insurance.
- Average cost ranges from $2,000 to $5,000.
- Insurance may cover the procedure if deemed medically necessary.
- Out-of-pocket costs depend on the patient's insurance plan.
Related CPT Codes
- 19125 - Excision of breast lesion
- 19110 - Biopsy of breast, percutaneous
- 19200 - Excision of Breast Lesion
- 19301 - Breast Reconstruction, Unilateral
- 19302 - Breast Reconstruction with Implant
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?
Yes, local or general anesthesia will be used to ensure comfort during the procedure.
How long is the recovery period?
Most patients can expect a recovery period of 1 to 2 weeks.
Are there any restrictions after the procedure?
Yes, avoid heavy lifting and strenuous activities for a few weeks.
