2025 CPT code 19294
(Active) Effective Date: N/A Surgery - Surgical Procedures on the Integumentary System Feed
Preparation of tumor cavity with placement of a radiation therapy applicator for intraoperative radiation therapy (IORT) during a partial mastectomy.
Modifiers may be applicable to code 19294 to indicate specific circumstances, such as reduced services (modifier 52), or discontinued procedures (modifiers 53, 73, 74). Other modifiers may be applicable based on specific payer guidelines.
Medical necessity for code 19294 must be supported by documentation showing the patient has a diagnosis that requires a partial mastectomy and that intraoperative radiation therapy (IORT) is a medically appropriate treatment strategy.This usually applies to early-stage breast cancers.The medical record should clearly demonstrate the clinical rationale for using IORT.
The surgeon performs the preparation of the tumor cavity, placement of the radiation therapy applicator, and the partial mastectomy. This includes enlarging the cavity, controlling bleeding, placing the applicator for IORT delivery, and completing the partial mastectomy procedure.IORT is typically indicated for early-stage breast cancer.
In simple words: During a partial mastectomy (surgery to remove part of the breast), the surgeon prepares the area where the tumor was removed and places a device to deliver radiation therapy right then and there. This targeted radiation treatment is given during the same surgery, and the device may be removed or left in place for further radiation after the operation.
Preparation of the tumor cavity and placement of a radiation therapy applicator for intraoperative radiation therapy (IORT) performed concurrently with a partial mastectomy. This involves enlarging the tumor cavity, controlling bleeding, and placing the applicator for IORT delivery, all performed during the same surgical session as the partial mastectomy (codes 19301, 19302).
Example 1: A patient undergoes a partial mastectomy for early-stage breast cancer.During the same surgical session, the surgeon prepares the tumor cavity and inserts an applicator to deliver intraoperative radiation therapy. The applicator is then removed., A patient with breast cancer has a partial mastectomy.After the tumor is removed, the surgeon places an IORT applicator into the cavity to deliver targeted radiation during the procedure. The applicator is left in place for additional postoperative radiotherapy., During a partial mastectomy for breast cancer, the surgeon performs extensive tissue removal, creating a large tumor cavity. The cavity is prepared, and a specialized applicator designed for larger areas is inserted for IORT delivery. The applicator is removed after the radiation treatment.
Documentation should include details of the partial mastectomy procedure, the size and location of the tumor cavity, the type and placement of the radiation therapy applicator used for IORT, the dosage of radiation delivered, and whether the applicator was removed or left in place for further treatment.
- Revenue Code: P7B (Oncology - Other)
- Payment Status: Active
- Specialties:Surgical Oncology, Breast Surgery, Radiation Oncology
- Place of Service:Ambulatory Surgical Center, Hospital - Inpatient, Hospital - Outpatient