Overview of CPT Code 23222:Excision of breast lesion
CPT Code 23222 refers to the surgical excision of a breast lesion, which may include tumors or abnormal growths. This procedure is performed to remove potentially cancerous or benign lesions for diagnostic and therapeutic purposes.
When CPT Code 23222 is Used?
This procedure is indicated in various clinical scenarios.
- Presence of a palpable breast mass that requires evaluation.
- Suspicious imaging findings suggesting a lesion.
- Biopsy results indicating atypical or malignant cells.
- Patient history of breast cancer with new lesions.
- Lesions causing pain or discomfort.
Symptoms Indicating This Procedure
Patients may report several symptoms that lead to the need for this procedure.
- A 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.
- Persistent pain in the breast area.
Causes and Risk Factors
Understanding the causes and risk factors can help in prevention and early detection.
- Family history of breast cancer.
- Genetic mutations such as BRCA1 and BRCA2.
- Previous breast lesions or biopsies.
- Age, particularly women over 40.
- Hormonal factors, including prolonged estrogen exposure.
Diagnostic Tests Before Procedure
Several tests may be conducted to assess the lesion before excision.
- Mammography to visualize breast tissue.
- Ultrasound to assess the characteristics of the lesion.
- MRI for detailed imaging of complex cases.
- Fine needle aspiration or core needle biopsy for histological evaluation.
Procedure Description
The excision procedure involves several key steps.
- Patient is positioned comfortably and prepped for surgery.
- Local anesthesia is administered to numb the area.
- 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.
- Consult with your healthcare provider about medications.
- Avoid blood thinners and certain supplements as advised.
- Arrange for transportation to and from the procedure.
- Follow fasting instructions if sedation is planned.
- Wear comfortable clothing and avoid jewelry.
Recovery and Aftercare
Post-operative care is crucial for healing.
- Rest for the first 24 hours post-surgery.
- Keep the surgical site clean and dry.
- Follow-up for suture removal as directed.
- Monitor for signs of infection such as increased redness or discharge.
- Pain management with prescribed medications as needed.
Possible Complications
While complications are rare, they can occur.
- Infection at the surgical site.
- Excessive bleeding or hematoma formation.
- Scarring or changes in breast appearance.
- Nerve damage leading to altered sensation.
- Recurrence of the lesion.
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 care is important for monitoring recovery.
- Schedule a follow-up appointment within 1-2 weeks.
- Review pathology results and discuss further treatment if necessary.
- Monitor healing and address any concerns.
- Regular breast exams as recommended by your healthcare provider.
Alternative Treatments
There are non-surgical options available for some patients.
- Observation for benign lesions without symptoms.
- Medications for pain management.
- Hormonal therapy for certain types of breast lesions.
- Radiation therapy for specific cancer cases.
Home Care Tips
Simple tips can aid in recovery at home.
- Keep the incision site clean and dry.
- Avoid strenuous activities for a few weeks.
- Wear a supportive bra as recommended.
- Stay hydrated and maintain a balanced diet.
- Report any unusual symptoms to your healthcare provider.
Patient Education & Prevention
Education is key to prevention and early detection.
- Perform regular breast self-exams.
- Schedule routine mammograms as advised.
- Discuss family history with your healthcare provider.
- Maintain a healthy lifestyle with diet and exercise.
- Be aware of changes in your breasts and report them promptly.
Billing and Coding Information
CPT Code: 23222
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.
- Insurance may cover the procedure if deemed medically necessary.
- Out-of-pocket costs depend on the insurance plan and deductible.
Related CPT Codes
- 19120 - Excision of Breast Lesion
- 19125 - Excision of breast lesion
- 19126 - Breast Biopsy, Needle, Percutaneous
- 19200 - Excision of Breast Lesion
- 19240 - Injection of breast lesion
Frequently Asked Questions (FAQs)
What should I expect during the procedure?
You will receive local anesthesia, and the procedure typically lasts about 30 minutes.
How long is the recovery period?
Most patients recover within a week, but full healing may take longer.
Will there be scarring after the excision?
Some scarring is possible, but it usually fades over time.
Can I return to normal activities after the procedure?
You should avoid strenuous activities for at least a week.
How will I know if the lesion is cancerous?
Pathology results from the excised tissue will determine if it is cancerous.
