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The CPT® Code 19126 refers to the excision of a breast lesion that has been identified through the preoperative placement of a radiological marker. This procedure is specifically designed for lesions that are nonpalpable, meaning they cannot be felt during a physical examination but have been detected via imaging techniques such as mammography or ultrasound. The use of a radiological marker is crucial as it provides a precise location for the surgeon to target during the excision process. The procedure involves making an incision in the breast tissue, guided by the marker, to remove the lesion along with a margin of surrounding healthy tissue to ensure complete removal. To manage any bleeding that may occur during the surgery, techniques such as electrocautery or ligation are employed. In some cases, a drain may be placed to prevent fluid accumulation at the surgical site. Finally, the incision is closed using layered sutures to promote optimal healing. It is important to note that CPT® Code 19126 is used in conjunction with CPT® Code 19125, which is designated for the excision of the first lesion, while 19126 is specifically for each additional lesion that has been separately identified by a radiological marker.
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The procedure associated with CPT® Code 19126 is indicated for the excision of additional breast lesions that have been identified through preoperative imaging techniques. The following conditions may warrant this procedure:
The procedure for excising additional breast lesions identified by a radiological marker involves several key steps:
After the procedure, patients are typically monitored for any immediate complications. Post-operative care may include instructions on wound care, signs of infection to watch for, and pain management strategies. Patients may also be advised on activity restrictions to promote healing. Follow-up appointments are essential to assess the surgical site and discuss pathology results from the excised tissue. The presence of a drain, if used, will require specific care and eventual removal by a healthcare professional.
| Short Descr | EXCISION ADDL BREAST LESION | Medium Descr | EXC BRST LES PREOP PLMT RAD MARKER OPN EA ADDL | Long Descr | Excision of breast lesion identified by preoperative placement of radiological marker, open; each additional lesion separately identified by a preoperative radiological marker (List separately in addition to code for primary procedure) | Status Code | Active Code | Global Days | ZZZ - Code Related to Another Service | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 0 - No payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 1 - Statutory payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 1 - Co-surgeons could be paid, though supporting documentation is required... | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Items and Services Packaged into APC Rates | ASC Payment Indicator | Packaged service/item; no separate payment made. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P5E - Ambulatory procedures - other | MUE | 3 | CCS Clinical Classification | 166 - Lumpectomy, quadrantectomy of breast |
This is an add-on code that must be used in conjunction with one of these primary codes.
| 19125 | MPFS Status: Active Code APC J1 ASC A2 Physician Quality Reporting CPT Assistant Article Illustration for Code Excision of breast lesion identified by preoperative placement of radiological marker, open; single lesion |
| 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) | 58 | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78. | 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. | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | GC | This service has been performed in part by a resident under the direction of a teaching physician | KX | Requirements specified in the medical policy have been met | 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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| 2011-01-01 | Changed | Short description changed. |
| 2001-01-01 | Changed | Code description changed. |
| 1994-01-01 | Added | First appearance in code book in 1994. |
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