Q: Can I code CPT 19125 and CPT 19126 if multiple preoperative wires/markers are inserted into a single mass that is excised from the breast?
A: No, in this scenario, you should code CPT 19125 only. The description for CPT codes 19125 and 19126 include the language “each lesion” rather than “each wire.” So, you should not count the total number of wires inserted, but instead, the total number of masses/lesions excised and identified by a preoperative marker. When a breast mass identified by multiple wires is excised, code CPT 19125 only.
Q: Can I code CPT 19125 and CPT 19126 if multiple masses identified by placement of a preoperative wire/marker are excised together with one large excision that encompasses both masses?
A: While I have not found a black and white reference from the AMA that addresses this scenario, I would recommend coding both CPT 19125 and CPT 19126. When the two masses are close together, that excision may be one large area encompassing both masses, but, nevertheless, two masses identified by a preoperative marker were excised. Again, because the description for CPT codes 19125 and 19126 include the language “each lesion,” if there are two masses identified by a preoperative marker and excised, coding both CPT 19125 and CPT 19126 aligns with those CPT descriptions.
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