Breast Procedure Coding in CPT - Excisional
Instructor
Beth Martilik, MA, RHIA, CDIP, CCSDescription
Excisional Breast Procedures Coding in CPT is an online, self-paced course designed for outpatient and professional fee coders who assign CPT codes for common breast surgeries. This module reviews key excisional procedures—including breast biopsy, partial mastectomy, complete mastectomy, and radical mastectomy—and explains how CPT guidelines define each service. You’ll also learn how sentinel node identification is performed and what documentation is required to support accurate code selection. The course includes 1 AHIMA CEU and helps coders code breast procedures with greater clarity and consistency.
Included Lessons:
- Breast Anatomy
- Breast Biopsies
- Sentinel Node Biopsy
- Mastectomies
- NCCI Policy Manual
- CPT Chapter Instructional Notes (19081 – 19272)
- CPT Assistant And Coding Clinic For HCPCS Coding Advice
CEUs available for the following credentials:
AHIMA
CCA, CCS, CCS-P, RHIT, RHIA, CDIP, CHDA, CHPS
Key Takeaways
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Mastery of Medical Coding for Breast Procedures: Gain a profound understanding of the specific medical codes associated with various excisional breast procedures such as biopsies, partial mastectomies, complete mastectomies, and radical mastectomies. Learn how to accurately assign these codes to ensure precise documentation and billing.
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Insights into Coding for Sentinel Node Identification: Learn the essential coding intricacies associated with sentinel node identification processes. Understand how to appropriately code for procedures that determine the extent of cancer’s spread within the lymphatic system.
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Enhancement of Billing Accuracy: Equip yourself with the knowledge to enhance billing accuracy by applying the most accurate and up-to-date medical codes, ensuring that services are billed correctly and facilitating smoother reimbursement processes.
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In-depth Knowledge of Coding Guidelines: Acquire in-depth insights into the latest coding guidelines and conventions pertinent to breast procedures and sentinel node identification, ensuring compliance with current industry standards.
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Effective Code Utilization: Learn how to effectively utilize codes to accurately represent the complexity and specificity of each breast procedure, contributing to clear and concise medical documentation.
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Understanding Code Modifications: Develop a nuanced understanding of how to use modifiers in coding to provide additional information about each procedure, enhancing the precision of the medical coding process.
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Knowledge of Reimbursement Processes: Gain knowledge of the reimbursement processes related to breast procedures, understanding how accurate coding influences the facilitation of payment and claim settlements.
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Practical Application of Coding Knowledge: Through practical examples and real-life scenarios, learn how to apply coding knowledge proficiently in a medical setting to ensure that breast procedures are accurately documented and reimbursed.
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Continuous Learning and Adaptation: Stay current with the evolving landscape of medical coding, adapting to new codes and guidelines to maintain accuracy and relevance in coding practices related to breast procedures.
Benefits of Taking this Course
- Enhanced Coding Accuracy
- Updated Coding Knowledge
- Streamlined Reimbursement Processes
- Practical Coding Application
- Improved Industry Compliance
FAQs
What will I learn about CPT coding for breast excisional procedures?
This course explains how to accurately select CPT codes for common breast excisional procedures, including lumpectomies, excisional biopsies, and tumor resections. You’ll learn how surgical intent, specimen handling, localization techniques, and margin assessment influence code assignment. By the end, you’ll be able to confidently translate operative report details into the correct CPT codes for both diagnostic and therapeutic breast excisions.
How does the course help coders interpret key documentation elements required for accurate breast procedure coding?
The course breaks down exactly what coders need to identify in the operative note—such as lesion location, number of lesions removed, presence of localization devices, margin status, and whether tissue was sent for pathology. Real documentation examples show how these details impact CPT code selection, helping coders avoid missed codes, unbundling issues, and common reporting errors.
Will this course improve my ability to distinguish between different types of breast excisions and when additional services may be separately reportable?
Yes. The course clarifies the differences between excisional biopsies, partial mastectomies, re-excisions, and procedures that involve imaging guidance or device localization. You’ll learn when additional services—such as image-guided localization or specimen radiography—can be reported separately and what documentation is required to support those codes.
About Our Medical Coding Courses
HIAlearn, powered by Health Information Associates (HIA)—a leader in medical coding and auditing for more than three decades—offers a flexible, online education platform designed for today’s coders. With a growing catalog of AHIMA and AAPC-approved coding courses, HIAlearn supports both beginners and experienced coders looking to build confidence, accuracy, and CEU credits.
Courses are available across various coding types including CPT, E/M, ICD-10-CM, and ICD-10-PCS, and are designed for multiple specialties including inpatient, outpatient, profee, and CDI.
To stay up to date, coders can explore our Coding Updates hub for the latest ICD-10-CM, ICD-10-PCS, CPT, and IPPS changes. HIAlearn also supports organizations with group discounts and scalable team access, promoting accuracy, compliance, and continuous professional development across departments.
Disclaimer: This course is not for individual sale. Purchase an annual or monthly subscription below and get access to 200+ courses.
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