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The CPT® Code 19296 refers to the procedure involving the placement of a radiotherapy afterloading expandable catheter into the breast for the purpose of interstitial radioelement application. This procedure is specifically performed following a partial mastectomy, which is a surgical operation that removes a portion of breast tissue while preserving the remaining breast. The placement of the catheter is crucial as it allows for targeted radiation therapy directly into the surgical cavity, which is the space left after the removal of the tissue. This method of delivering radiation is known as interstitial radiotherapy, and it is designed to treat the area where the tumor was located, along with a small margin of surrounding tissue, rather than irradiating the entire breast. The use of an expandable catheter, which can be either single or multichannel, enhances the precision of the treatment. The procedure is typically completed in a matter of days, significantly reducing the treatment time compared to traditional radiation therapy that may span several weeks. The process begins with the creation of a pathway into the surgical cavity using a trocar, which is guided by ultrasound imaging. Once the pathway is established, the trocar is removed, and the applicator is inserted into the cavity in a closed position. The catheter is then expanded to fit the cavity's dimensions, allowing for optimal placement and delivery of the radiation source. This technique combines the advantages of tissue-sparing interstitial brachytherapy with the convenience of intracavitary balloon brachytherapy, providing a flexible and effective treatment option for patients. It is important to note that this procedure can be performed on a date separate from the partial mastectomy or on the same day, depending on the clinical scenario.
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The procedure associated with CPT® Code 19296 is indicated for patients who have undergone a partial mastectomy, lumpectomy, or excisional biopsy and require targeted radiation therapy to the surgical cavity. The following conditions may warrant the use of this procedure:
The procedure for CPT® Code 19296 involves several key steps to ensure the successful placement of the radiotherapy afterloading expandable catheter:
After the placement of the radiotherapy afterloading expandable catheter, patients may require specific post-procedure care to ensure proper healing and effectiveness of the treatment. Monitoring for any signs of complications, such as infection or excessive bleeding, is essential. Patients may also need follow-up imaging to confirm the correct placement of the catheter and to assess the response to the radiation therapy. The recovery period is typically shorter than that of traditional radiation therapy, with treatment completed in a matter of days. Patients should be informed about any potential side effects of the radiation therapy and the importance of adhering to follow-up appointments for ongoing evaluation and care.
| Short Descr | PLACE PO BREAST CATH FOR RAD | Medium Descr | PLMT EXPANDABLE CATH BRST FOLLOWING PRTL MAST | Long Descr | Placement of radiotherapy afterloading expandable catheter (single or multichannel) into the breast for interstitial radioelement application following partial mastectomy, includes imaging guidance; on date separate from partial mastectomy | Status Code | Active Code | Global Days | 000 - Endoscopic or Minor Procedure | 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 | Device-intensive procedure added to ASC list in CY 2008 or later; paid at adjusted rate. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P1A - Major procedure - breast | MUE | 1 | CCS Clinical Classification | 175 - Other OR therapeutic procedures on skin and breast |
| 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. | RT | Right side (used to identify procedures performed on the right side of the body) | LT | Left side (used to identify procedures performed on the left side of the body) | 50 | Bilateral procedure: unless otherwise identified in the listings, bilateral procedures that are performed at the same session, should be identified by adding modifier 50 to the appropriate 5 digit code. note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 53 | Discontinued procedure: under certain circumstances, the physician or other qualified health care professional may elect to terminate a surgical or diagnostic procedure. due to extenuating circumstances or those that threaten the well being of the patient, it may be necessary to indicate that a surgical or diagnostic procedure was started but discontinued. this circumstance may be reported by adding modifier 53 to the code reported by the individual for the discontinued procedure. note: this modifier is not used to report the elective cancellation of a procedure prior to the patient's anesthesia induction and/or surgical preparation in the operating suite. for outpatient hospital/ambulatory surgery center (asc) reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use). | 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.) | 79 | Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.) |
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| 2009-01-01 | Changed | Code description changed |
| 2005-01-01 | Added | First appearance in code book in 2005. |
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