Partial Mastectomy or Lumpectomy?
Instead of determining if the excision meets the requirements for a partial mastectomy, Bucknam focuses on the lumpectomy. “I ask, ‘Does the procedure, as documented, meet or exceed the requirements for a lumpectomy?’ In other words, was more than a lump and surrounding tissue removed? If so, a partial mastectomy was probably performed. Otherwise, it’s a 19120.” Bucknam notes that in some cases, a lumpectomy is begun but, because the margins of the mass extend quite far, the surgeon cuts further than he or she normally would to be sure all malignant tissue has been excised. In some cases, more than a quadrant (25 percent) of the breast has been removed (i.e., a partial mastectomy), which is appropriately reported using 19160. Often surgeons make two excisions. The first is coded 19120 because most surgeons take a margin of tissue so that another excision will not be necessary if the biopsy returns positive (malignant). If the margins subsequently return positive (meaning the tumor now
