Overview of CPT Code 19310:breast-mastectomy-total
CPT Code 19310 refers to a total breast mastectomy, a surgical procedure that involves the complete removal of one or both breasts. This procedure is typically performed to treat breast cancer or to prevent its development in high-risk patients.
When CPT Code 19310 is Used?
This code is applicable in various clinical scenarios.
- Diagnosis of invasive breast cancer requiring mastectomy.
- Prophylactic mastectomy in patients with a high genetic risk for breast cancer.
- Recurrent breast cancer after previous treatment.
- Severe breast disease that cannot be managed with less invasive procedures.
Symptoms Indicating This Procedure
Patients may present with several symptoms that lead to the consideration of a total mastectomy.
- Palpable lump in the breast.
- Changes in breast shape or size.
- Nipple discharge or inversion.
- Skin changes over the breast, such as dimpling or redness.
Causes and Risk Factors
Several factors can increase the likelihood of needing a total mastectomy.
- Family history of breast cancer.
- Genetic mutations such as BRCA1 or BRCA2.
- Previous radiation therapy to the breast.
- Age, particularly women over 50.
Diagnostic Tests Before Procedure
Several tests are conducted to confirm the need for a mastectomy.
- Mammography to detect abnormalities.
- Ultrasound to evaluate breast lumps.
- MRI for detailed imaging of breast tissue.
- Biopsy to confirm the presence of cancer.
Procedure Description
The total mastectomy procedure involves several key steps.
- Patient is placed under general anesthesia.
- Incision is made across the breast to remove breast tissue.
- Lymph nodes may be removed for further evaluation.
- Incision is closed with sutures or staples.
- Dressings are applied to the surgical site.
Preparation for the Procedure
Proper preparation is essential for a successful surgery.
- Avoid eating or drinking after midnight before the surgery.
- Discuss medications with the healthcare provider.
- Arrange for transportation to and from the hospital.
- Prepare a recovery area at home with necessary supplies.
Recovery and Aftercare
Post-operative care is crucial for healing.
- Rest for several days following the surgery.
- Monitor the surgical site for signs of infection.
- Follow-up appointments to check healing progress.
- Pain management with prescribed medications.
Possible Complications
As with any surgery, there are potential risks involved.
- Infection at the surgical site.
- Bleeding or hematoma formation.
- Changes in sensation in the breast or chest area.
- Lymphedema, or swelling due to lymph fluid buildup.
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Post-Procedure Follow-Up
Regular follow-up is important for monitoring recovery.
- Initial follow-up within one to two weeks post-surgery.
- Regular check-ups every few months for the first year.
- Annual mammograms or imaging as recommended.
Alternative Treatments
There are non-surgical options available for breast conditions.
- Lumpectomy for localized tumors.
- Radiation therapy to shrink tumors.
- Hormonal therapy for hormone-sensitive cancers.
- Chemotherapy for systemic treatment.
Home Care Tips
Patients can take steps to aid their recovery at home.
- Keep the surgical area clean and dry.
- Wear a supportive bra as advised.
- Engage in light activities as tolerated.
- Stay hydrated and maintain a balanced diet.
Patient Education & Prevention
Education is key to preventing recurrence.
- Regular breast self-exams and clinical exams.
- Genetic counseling for those with family history.
- Healthy lifestyle choices, including diet and exercise.
- Awareness of changes in breast tissue.
Billing and Coding Information
CPT Code: 19310
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 $15,000 to $30,000.
- Insurance typically covers medically necessary procedures.
- Out-of-pocket costs depend on the insurance plan.
Related CPT Codes
- 19303 - Breast Reconstruction with Implant
- 19307 - Breast Reconstruction with Implant
- 19340 - Breast Reconstruction with Implant
- 19301 - Breast Reconstruction, Unilateral
- 19302 - Breast Reconstruction with Implant
References and Sources
Frequently Asked Questions (FAQs)
What is a total mastectomy?
A total mastectomy involves the complete removal of one or both breasts.
How long is the recovery period?
Recovery typically takes several weeks, with follow-up care needed.
Will I need reconstruction after surgery?
Reconstruction is an option and can be discussed with your surgeon.
What are the risks of this procedure?
Risks include infection, bleeding, and changes in sensation.
