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The CPT® Code 19298 refers to the procedure involving the placement of radiotherapy after-loading brachytherapy catheters, specifically designed in multiple tube and button types, into the breast. This procedure is performed for interstitial radioelement application following a partial mastectomy. The placement of these catheters can occur either concurrently with the mastectomy or at a later date. The process begins with determining the optimal distribution of the catheters, which is established in a separately reportable procedure. Subsequently, implant needles are inserted into the breast tissue, adhering to the predetermined distribution pattern, and this can be done under direct vision or with the aid of imaging guidance. Once the needles are accurately positioned, the distribution is verified to ensure comprehensive coverage of the area designated for brachytherapy treatment. The implant needles are then replaced with the after-loading brachytherapy tube catheters, which are threaded through the previously placed needles. As the needles are withdrawn, a button-shaped end piece on the catheter secures its position within the breast tissue. To further stabilize the catheter, a second fixing button is threaded over the exposed end of the catheter that extends from the skin. Any excess catheter material that protrudes is trimmed to ensure a neat and secure fit. Additionally, stiffening devices within the catheters are removed, and each catheter is assessed for patency by passing a non-radioactive dummy cable through it. The ends of the catheters are then prepared to connect with the radiotherapy after-loader tubing. To protect the catheters from kinking, special padding and a dressing are applied over the breast. It is important to note that the actual loading of the catheters with radioactive material and the execution of the brachytherapy procedure will occur in a separately reportable procedure, ensuring that all aspects of the treatment are documented and billed appropriately.
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The procedure described by CPT® Code 19298 is indicated for patients who have undergone a partial mastectomy and require localized radiotherapy treatment. The specific indications for this procedure include:
The procedure for CPT® Code 19298 involves several critical steps to ensure the effective placement of brachytherapy catheters. The steps are as follows:
After the placement of the brachytherapy catheters, patients may require specific post-procedure care to ensure proper healing and to monitor for any complications. It is essential to observe the insertion sites for signs of infection or unusual swelling. Patients should be advised to avoid any activities that may dislodge the catheters or cause strain on the breast tissue. Follow-up appointments will be necessary to assess the placement of the catheters and to prepare for the subsequent brachytherapy procedure, which will be reported separately. Proper documentation of the procedure and any post-operative instructions given to the patient is crucial for compliance and billing purposes.
| Short Descr | PLACE BREAST RAD TUBE/CATHS | Medium Descr | PLMT RADTHX BRACHYTX BRST FOLLOWING PRTL MAST | Long Descr | Placement of radiotherapy after loading brachytherapy catheters (multiple tube and button type) into the breast for interstitial radioelement application following (at the time of or subsequent to) partial mastectomy, includes imaging guidance | 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 |
| GC | This service has been performed in part by a resident under the direction of a teaching physician | RT | Right side (used to identify procedures performed on the right 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). | 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). | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | LT | Left side (used to identify procedures performed on the left side of the body) | Q1 | Routine clinical service provided in a clinical research study that is in an approved clinical research study | Q6 | Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area |
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| 2017-01-01 | Changed | Long description changed and Moderate (Conscious) Sedation flag removed. See new Moderate Sedation category. |
| 2005-01-01 | Added | First appearance in code book in 2005. |
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