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The CPT® Code 19112 refers to the excision of a lactiferous duct fistula, a procedure that addresses complications arising from the lactiferous ducts in the breast. A lactiferous duct fistula is an abnormal connection that forms between the duct and the skin, often resulting from obstruction, infection, or previous surgical interventions such as incision and drainage of a breast abscess or excision of a breast lesion. The procedure typically begins with nipple exploration to diagnose the underlying cause of symptoms, such as bloody discharge from the nipple. This discharge is frequently associated with benign lesions, such as papillomas, which may not be palpable during a physical examination. The physician performs a thorough examination of the nipple and surrounding tissues, often utilizing techniques such as ductoscopy to visualize the ductal system. If a fistula is identified, the surgeon will make an incision over the fistulous tract to excise it, along with the obstructed duct and any surrounding inflamed tissue, which may include portions of the skin of the areola and nipple. This excision aims to alleviate symptoms and prevent further complications associated with the ductal obstruction and infection.
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The procedure coded as CPT® 19112 is indicated for the following conditions:
The procedure for excising a lactiferous duct fistula involves several critical steps:
After the excision of the lactiferous duct fistula, the patient may require specific post-procedure care to ensure proper healing and recovery. This may include monitoring for signs of infection, managing pain, and following up with the physician to assess the surgical site. Patients are typically advised on wound care and may need to avoid certain activities that could strain the area. The expected recovery time can vary based on the extent of the procedure and the individual's overall health, but close follow-up is essential to ensure that the duct has healed properly and that there are no complications.
| Short Descr | EXCISE BREAST DUCT FISTULA | Medium Descr | EXCISION LACTIFEROUS DUCT FISTULA | Long Descr | Excision of lactiferous duct fistula | Status Code | Active Code | Global Days | 090 - Major Surgery | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 2 - Standard payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 1 - 150% payment adjustment for bilateral procedures applies. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 0 - Payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Hospital Part B services paid through a comprehensive APC | ASC Payment Indicator | Surgical procedure on ASC list in CY 2007; payment based on OPPS relative payment weight. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P1A - Major procedure - breast | MUE | 2 | CCS Clinical Classification | 175 - Other OR therapeutic procedures on skin and breast |
| 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 78 | Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.) | GC | This service has been performed in part by a resident under the direction of a teaching physician | LT | Left side (used to identify procedures performed on the left side of the body) | RT | Right side (used to identify procedures performed on the right side of the body) | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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| Pre-1990 | Added | Code added. |
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