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The CPT® Code 19297 refers to the placement of a radiotherapy afterloading expandable catheter, which can be either single or multichannel, into the breast for the purpose of interstitial radioelement application following a partial mastectomy. This procedure is performed in conjunction with imaging guidance and is specifically noted to be listed separately in addition to the code for the primary procedure. The primary aim of this intervention is to deliver targeted radiation therapy directly into the surgical cavity created by the partial mastectomy, lumpectomy, or excisional biopsy. Unlike traditional radiation therapy that irradiates the entire breast, this method focuses on the surgical site and a small surrounding margin, allowing for a more localized treatment approach. This technique not only enhances the precision of radiation delivery but also significantly reduces the overall treatment duration, completing the therapy in a matter of days rather than weeks. The procedure involves making a single incision, through which a trocar is inserted into the surgical cavity under ultrasound guidance to facilitate the placement of the expandable catheter. Once the trocar is removed, the applicator is introduced into the cavity in a closed position, and an expansion tool is utilized to deploy the catheter, which typically consists of multiple lumens surrounding a central lumen. This design allows the catheter to expand and conform to the cavity's size, ensuring optimal placement for effective radiation delivery. The catheter is then connected to an after-loading device that administers the radiation source, providing a flexible and controlled treatment option that combines the advantages of tissue-sparing interstitial brachytherapy with the convenience of intracavitary balloon brachytherapy. This procedure can be performed either on the same day as the lumpectomy or partial mastectomy or on a subsequent date, depending on the clinical scenario.
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The placement of a radiotherapy afterloading expandable catheter (CPT® Code 19297) is indicated for patients who have undergone a partial mastectomy, lumpectomy, or excisional biopsy and require localized radiation therapy. The specific indications for this procedure include:
The procedure for the placement of the radiotherapy afterloading expandable catheter involves several key steps, which are detailed as follows:
After the placement of the radiotherapy afterloading expandable catheter, patients may experience some post-procedure care considerations. It is important to monitor the surgical site for any signs of infection or complications. Patients are typically advised on the expected recovery timeline and any necessary follow-up appointments for radiation therapy. The localized nature of this treatment often results in a quicker recovery compared to traditional radiation therapy, allowing patients to resume normal activities sooner. Additionally, healthcare providers may provide specific instructions regarding activity restrictions and wound care to ensure optimal healing and treatment efficacy.
| Short Descr | PLACE BREAST CATH FOR RAD | Medium Descr | PLMT EXPANDABLE CATH BRST CONCURRENT 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; concurrent with partial mastectomy (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) | 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 | 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) | P1A - Major procedure - breast | MUE | 2 | 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.
| 19301 | MPFS Status: Active Code APC J1 ASC A2 Physician Quality Reporting CPT Assistant Article Illustration for Code Mastectomy, partial (eg, lumpectomy, tylectomy, quadrantectomy, segmentectomy); | 19302 | MPFS Status: Active Code APC J1 ASC A2 Physician Quality Reporting CPT Assistant Article Illustration for Code Mastectomy, partial (eg, lumpectomy, tylectomy, quadrantectomy, segmentectomy); with axillary lymphadenectomy |
| AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | 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. | 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.) | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | 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) |
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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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