CPT® Code 19260

Code deleted, see 21601

Official Description

Excision of chest wall tumor including ribs

Common Language Description

The procedure described by CPT® Code 19260 involves the excision of a tumor located in the chest wall, which is the structure composed of bones and muscles that encase the chest cavity, safeguarding vital organs such as the lungs, heart, and major blood vessels. Tumors in this area can be classified as benign or malignant, with benign tumors typically not invading surrounding tissues or spreading to other parts of the body, although they may require removal due to their size or location. In contrast, malignant tumors have the potential to invade adjacent tissues or metastasize to distant organs, necessitating appropriate treatment. The tumors can be categorized further into primary tumors, which originate from the chest wall itself, and secondary tumors, which arise from other locations in the body and spread to the chest wall. In the procedure associated with CPT® Code 19260, the excision involves not only the tumor but also the ribs that are affected. The surgical process begins with an incision through the skin over the tumor, followed by the opening of the chest cavity. The excision is comprehensive, removing the full thickness of the chest wall, including the adjacent pleura, along with a margin of healthy tissue measuring approximately 4-5 centimeters. Additionally, the procedure requires the resection of the involved rib as well as at least one rib above and below the tumor site. It is important to note that this procedure does not include any reconstruction of the chest wall following the excision, distinguishing it from related procedures that may involve reconstruction efforts.

1. Indications

The procedure associated with CPT® Code 19260 is indicated for the excision of tumors located in the chest wall. The following conditions may warrant this surgical intervention:

Benign Tumors - These tumors may require excision due to their size or location, even though they do not invade surrounding tissues or metastasize.
Malignant Tumors - Tumors that are cancerous and have the potential to invade adjacent tissues or spread to other organs necessitate removal to prevent further complications.
Primary Tumors - Tumors that originate from the chest wall structures may require excision to eliminate the source of the malignancy.
Secondary Tumors - Tumors that have metastasized to the chest wall from other parts of the body may also be indicated for excision to manage the spread of cancer.

2. Procedure

The procedure for CPT® Code 19260 involves several critical steps to ensure the complete excision of the chest wall tumor and the affected ribs. The following procedural steps are outlined:

Step 1: Incision - The surgical process begins with an incision made through the skin directly over the tumor. This incision allows access to the underlying structures of the chest wall.
Step 2: Opening the Chest - Following the skin incision, the chest cavity is opened to provide visibility and access to the tumor and surrounding tissues.
Step 3: Tumor and Tissue Resection - The full thickness of the chest wall, including the adjacent pleura, is resected. This step is crucial to ensure that all tumor cells are removed, along with a margin of healthy tissue measuring approximately 4-5 centimeters to minimize the risk of recurrence.
Step 4: Rib Resection - The involved rib, along with at least one rib above and below the level of the tumor, is excised. This ensures that any potential tumor spread to the rib structures is adequately addressed.
Step 5: Closure - After the tumor and affected ribs have been removed, the chest cavity is closed. It is important to note that this procedure does not include any reconstruction of the chest wall.

3. Post-Procedure

Post-procedure care following the excision of a chest wall tumor involves monitoring for complications such as infection, bleeding, or respiratory issues. Patients may require pain management and should be advised on activity restrictions to promote healing. Follow-up appointments are essential to assess recovery and ensure that there are no signs of tumor recurrence. The specific recovery timeline may vary based on the individual patient's health status and the extent of the surgery performed.

Short Descr	REMOVAL OF CHEST WALL LESION
Medium Descr	EXCISION CHEST WALL TUMOR INCLUDING RIBS
Long Descr	Excision of chest wall tumor including ribs
Status Code	Active Code
Global Days	090 - Major Surgery
PC/TC Indicator (26, TC)	0 - Physician Service Code
Multiple Procedures (51)	2 - Standard 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)	2 - Payment restriction for assistants at surgery does not apply to this procedure...
Co-Surgeons (62)	1 - Co-surgeons could be paid, though supporting documentation is required...
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
Type of Service (TOS)	2 - Surgery
Berenson-Eggers TOS (BETOS)	P1G - Major procedure - Other
MUE	Not applicable/unspecified.
CCS Clinical Classification	142 - Partial excision bone