{"id":178953,"date":"2026-08-14T13:36:46","date_gmt":"2026-08-14T13:36:46","guid":{"rendered":"https:\/\/pabau.com\/?p=178953"},"modified":"2026-08-14T14:38:32","modified_gmt":"2026-08-14T14:38:32","slug":"cpt-code-19304","status":"publish","type":"post","link":"https:\/\/pabau.com\/de\/procedure-codes\/cpt-code-19304\/","title":{"rendered":"CPT code 19304: Why it&#8217;s deleted and what to bill now"},"content":{"rendered":"\n<script type=\"application\/ld+json\">{\"@context\":\"https:\/\/schema.org\",\"@type\":\"MedicalWebPage\",\"headline\":\"CPT code 19304: Why it's deleted and what to bill now\",\"description\":\"CPT code 19304 is deleted, so any claim carrying it is denied. See which code replaces it, the modifiers to use, and how to clear it from billing. Read more.\",\"url\":\"https:\/\/pabau.com\/procedure-codes\/cpt-code-19304\/\",\"audience\":{\"@type\":\"MedicalAudience\",\"audienceType\":\"Clinician\"},\"reviewedBy\":{\"@type\":\"Person\",\"name\":\"Dr Vanja Kitanova\",\"jobTitle\":\"Medical Reviewer\",\"affiliation\":{\"@type\":\"Organization\",\"name\":\"Pabau\"},\"knowsAbout\":[\"Medical Coding\",\"Clinical Documentation\",\"Healthcare Billing\",\"Clinical Safety\"],\"sameAs\":\"https:\/\/pabau.com\/blog\/author\/vanja\/\"},\"datePublished\":\"2026-08-10\",\"dateModified\":\"2026-08-14\"}<\/script>\n\n\n        <div id=\"key_takeaways\">\n            <div class=\"header\">\n                                    <img decoding=\"async\" src=\"https:\/\/pabau.com\/wp-content\/uploads\/2025\/12\/Key-Takeaways-Icon.svg\" alt=\"Key takeaways\" height=\"42\" width=\"42\">\n                                <h3>Key takeaways<\/h3>\n            <\/div>\n            <div class=\"list\">\n                                                            <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#3D3D46\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p>CPT code 19304 described a subcutaneous mastectomy, which removes glandular breast tissue but leaves the skin and usually the nipple in place.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#3D3D46\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p>The code is deleted, so every claim carrying 19304 comes back from the payer as an invalid procedure code.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#3D3D46\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p>CPT 19303 is the replacement the American College of Surgeons names, with modifier 50 or LT and RT for laterality.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#3D3D46\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p>Clear 19304 out of your charge master, superbill, and note templates, or the denials keep arriving.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#3D3D46\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p>Practice management software like Pabau checks the insurer fields a claim needs, such as membership and authorization numbers, before it can be sent.<\/p>\n                        <\/div>\n                                                <\/div>\n        <\/div>\n    \n\n\n<p class=\"wp-block-paragraph\">CPT code 19304 no longer exists. The American Medical Association (AMA) retired it from the <a href=\"https:\/\/www.ama-assn.org\/practice-management\/cpt\/cpt-code-set-overview\" target=\"_blank\" rel=\"nofollow noopener\">CPT code set<\/a>. Payers now reject it on sight as an invalid procedure code.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The surgery itself hasn&#8217;t gone anywhere. Surgeons still perform subcutaneous mastectomies, removing glandular breast tissue while leaving the skin envelope and usually the nipple in place. Only the billing moved. It now runs through CPT 19303, and practices that never updated their charge master are still collecting denials for the old code.<\/p>\n\n\n\n<figure class=\"wp-block-embed is-type-video is-provider-youtube wp-block-embed-youtube wp-embed-aspect-16-9 wp-has-aspect-ratio\"><div class=\"wp-block-embed__wrapper\">\n<iframe title=\"CPT Coding Pitfalls Every Medical Practice Faces\" width=\"800\" height=\"450\" src=\"https:\/\/www.youtube.com\/embed\/vbvV5okdXKg?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" referrerpolicy=\"strict-origin-when-cross-origin\" allowfullscreen><\/iframe>\n<\/div><\/figure>\n\n\n\n<h2 id=\"h-what-19304-covered-before-it-was-deleted\" class=\"wp-block-heading\">What 19304 covered before it was deleted<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">CPT code 19304 described a subcutaneous mastectomy. The surgeon removes the glandular breast tissue and leaves the overlying skin envelope in place. In most cases the nipple-areola complex (NAC) stays too.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">That makes it a different operation from a total or modified radical mastectomy. Those remove the breast tissue, the skin, and the NAC as well. Here the skin and nipple stay for cosmetic and reconstructive reasons. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Common indications were early-stage breast cancer where skin preservation was appropriate. The other was prophylactic surgery in high-risk patients, such as BRCA1 or BRCA2 carriers.<\/p>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Field<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Details<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Code<\/td>\n<td style=\"padding:12px 16px;color:#374151\">19304<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Former description<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Mastectomy, subcutaneous<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Code set<\/td>\n<td style=\"padding:12px 16px;color:#374151\">CPT (Current Procedural Terminology), AMA<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Anatomical area<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Breast, with skin and NAC preservation<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Current status<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Deleted, do not bill<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Primary replacement<\/td>\n<td style=\"padding:12px 16px;color:#374151\">CPT 19303, mastectomy, simple, complete<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<p class=\"wp-block-paragraph\">The clinical detail a coder has to pull out of the operative report has not changed. Four points still decide whether the claim holds up:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>How much tissue came out.<\/li>\n\n\n\n<li>Whether the skin envelope was preserved.<\/li>\n\n\n\n<li>What happened to the nipple-areola complex.<\/li>\n\n\n\n<li>Whether the surgery was therapeutic or prophylactic.<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">All four now support CPT 19303 instead of 19304.<\/p>\n\n\n\n<h2 id=\"h-why-the-ama-retired-19304\" class=\"wp-block-heading\">Why the AMA retired 19304<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">19304 came out of the code set because it kept getting reported for operations it did not describe. Skin-sparing and nipple-sparing mastectomies were billed under it for years. Both of those remove the whole gland, which is exactly what CPT 19303 already covers.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">This is not a coding error a modifier can rescue. There is nothing to append to a code that no longer exists in the billable set. A claim with 19304 on it fails the payer&#8217;s edit before anyone reads the clinical detail.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">So the practices still generating denials are the ones whose systems never caught up. If 19304 is live in your charge master, your superbill, or your <a href=\"https:\/\/pabau.com\/blog\/ehr-integration\/\">EHR integration<\/a> templates, it will keep going out on claims. The steps for clearing it are further down.<\/p>\n\n\n        <div id=\"pro_tip\">\n            <div class=\"img\">\n                <svg width=\"42\" height=\"42\" viewBox=\"0 0 42 42\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                    <path fill-rule=\"evenodd\" clip-rule=\"evenodd\"\n                        d=\"M12.6383 19.5238C12.6632 21.2071 12.8734 22.9926 12.0685 24.5523C11.0341 26.8917 8.45076 28.169 7.56292 30.5918C6.63082 33.1061 7.19505 36.185 9.31371 37.9786C10.929 39.5678 13.4183 39.9873 15.6061 39.5463C17.4592 39.073 19.1049 37.8388 19.9706 36.1608C20.781 34.7141 20.7866 32.9904 20.5293 31.3985C20.1006 29.3092 18.3775 27.8705 16.9807 26.362C14.8814 24.1005 14.6684 20.6854 15.595 17.8915C16.4331 15.4768 19.0026 14.2344 20.0425 11.9461C20.7202 10.6769 20.7506 9.20327 20.6068 7.81304C20.1864 5.40098 18.3139 3.23631 15.8716 2.56674C13.9742 2.03969 11.8224 2.30052 10.1739 3.37614C8.70522 4.34688 7.5878 5.86618 7.28356 7.58178C6.76081 9.82981 7.53525 12.2822 9.20307 13.9118C10.7658 15.4741 12.4806 17.2273 12.6383 19.5238Z\"\n                        fill=\"#2BADD4\" \/>\n                    <path fill-rule=\"evenodd\" clip-rule=\"evenodd\"\n                        d=\"M22.7048 19.8387C22.6822 22.3279 24.4507 24.6234 26.7493 25.4682C28.0531 25.961 29.4725 25.9183 30.7989 25.5487C32.0575 24.9955 33.301 24.2237 34.0069 23.0092C34.8384 21.5811 35.2982 19.8286 34.7832 18.2094C34.3611 16.2507 32.8739 14.6541 31.0275 13.9426C28.6736 12.9595 25.8073 13.7942 24.1719 15.7001C23.2022 16.8366 22.6143 18.3326 22.7048 19.8387Z\"\n                        fill=\"#2BADD4\" \/>\n                <\/svg>\n            <\/div>\n            <div class=\"text\">\n                <h3>Pro Tip<\/h3>\n                <p>Run a charge master audit every quarter. Filter for any CPT code your system flags as deleted or invalid. One missed deletion can generate months of denials before anyone traces the cause.<\/p>\n            <\/div>\n        <\/div>\n    \n\n\n<h2 id=\"h-cpt-19303-is-what-you-bill-instead\" class=\"wp-block-heading\">CPT 19303 is what you bill instead<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">CPT 19303, mastectomy, simple, complete, is the replacement. The <a href=\"https:\/\/www.facs.org\/for-medical-professionals\/practice-management\/coding-and-billing\/\" target=\"_blank\" rel=\"nofollow noopener\">American College of Surgeons<\/a> (ACS) names it as the correct code for the work that used to go out under 19304.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">What changes is what you have to prove. 19303 describes removal of the whole gland. When the skin and NAC are preserved, the operative report has to say so in plain terms. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\">A reviewer reading &#8222;total mastectomy&#8220; expects a different picture. Medical necessity policies also vary by payer, so the clinical rationale belongs in the note.<\/p>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Scenario<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Code to use<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Notes<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Unilateral, one breast<\/td>\n<td style=\"padding:12px 16px;color:#374151\">19303 + LT or RT<\/td>\n<td style=\"padding:12px 16px;color:#374151\">LT for the left breast, RT for the right<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Bilateral, same session<\/td>\n<td style=\"padding:12px 16px;color:#374151\">19303 + 50, or 19303-LT and 19303-RT<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Some payers want modifier 50, others want two lateral lines<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Prophylactic, high-risk patient<\/td>\n<td style=\"padding:12px 16px;color:#374151\">19303 + Z15.01<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Z15.01 covers BRCA1 and BRCA2 breast susceptibility<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">With sentinel node biopsy<\/td>\n<td style=\"padding:12px 16px;color:#374151\">19303 + 38792 or 38900<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Check NCCI edits first, because the node codes may bundle<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<p class=\"wp-block-paragraph\">Here is how that plays out on a real claim. A BRCA1 carrier has a bilateral prophylactic mastectomy with both nipples preserved. You bill 19303 twice with LT and RT, or once with modifier 50, depending on what the payer accepts. Z15.01 goes on as the diagnosis, and the operative note records that both nipples were spared.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Verify the assignment against the payer&#8217;s Local Coverage Determination (LCD) before you submit. ACS guidance names 19303, but individual payers add their own modifier formats and documentation requirements on top.<\/p>\n\n\n\n<h2 id=\"h-laterality-drives-your-modifier-choice\" class=\"wp-block-heading\">Laterality drives your modifier choice<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">For 19303, the modifier almost always comes down to which side was operated on. The modifiers that applied to 19304 carry over unchanged, because the surgery is the same. Complexity and payer preference decide the rest.<\/p>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Modifier<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Description<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">When to apply<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">LT<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Left side<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Unilateral procedure on the left breast<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">RT<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Right side<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Unilateral procedure on the right breast<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">50<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Bilateral procedure<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Both breasts in the same session, if the payer prefers one line<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">22<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Increased procedural services<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Work well beyond the typical case, with documentation to match<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">53<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Discontinued procedure<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Surgery started, then stopped because of patient condition or risk<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">62<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Two surgeons<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Two surgeons with distinct roles, and both append the modifier<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<p class=\"wp-block-paragraph\">Payer rules differ here, and the difference costs money. Medicare follows the <a href=\"https:\/\/www.cms.gov\/medicare\/coding-billing\/national-correct-coding-initiative-ncci-edits\" target=\"_blank\" rel=\"nofollow noopener\">National Correct Coding Initiative<\/a> (NCCI) edits. Those edits set out which codes can be billed together, and when a modifier can break a bundle. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Private payers publish their own policies. Treat every modifier above as commonly applied, then check the payer&#8217;s rules before the claim goes out.<\/p>\n\n\n\n<h2 id=\"h-reimbursement-now-runs-through-19303\" class=\"wp-block-heading\">Reimbursement now runs through 19303<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Because 19304 is deleted, payment for these operations comes through 19303. Historical Medicare amounts for 19304 are gone from the Physician Fee Schedule (MPFS). If you find 19304 in an old fee schedule file, treat it as an archive entry. It is not a rate to bill or negotiate against.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">For live numbers, look up 19303 in the <a href=\"https:\/\/www.cms.gov\/medicare\/physician-fee-schedule\/search\/overview\" target=\"_blank\" rel=\"nofollow noopener\">CMS MPFS lookup tool<\/a>. Three things move the rate:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Geographic locality:<\/strong> CMS adjusts rates by region using the Geographic Practice Cost Index (GPCI).<\/li>\n\n\n\n<li><strong>Place of service:<\/strong> Office rates usually beat facility rates. Mastectomies are almost always facility cases, so the facility rate is the one that applies.<\/li>\n\n\n\n<li><strong>Year:<\/strong> CMS updates the MPFS annually, so check the current-year figure before you bill.<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Commercial rates are negotiated separately and generally sit above Medicare. If the practice also treats <a href=\"https:\/\/pabau.com\/blog\/self-pay-patients\/\">self-pay patients<\/a>, price the procedure from the same 19303 basis. Your quotes and your claims should agree.<\/p>\n\n\n\n<h2 id=\"h-the-diagnosis-code-is-what-proves-medical-necessity\" class=\"wp-block-heading\">The diagnosis code is what proves medical necessity<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">The ICD-10-CM code linked to 19303 is what tells the payer the surgery was warranted. Payers read that diagnosis-to-procedure pairing before they look at anything else. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The codes below are the ones that show up most often on mastectomy claims.<\/p>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">ICD-10-CM code<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Description<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Clinical context<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">C50.x<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Malignant neoplasm of breast, with sub-codes by site<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Therapeutic mastectomy for confirmed breast cancer<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">D05.x<\/td>\n<td style=\"padding:12px 16px;color:#374151\">In situ carcinoma of breast<\/td>\n<td style=\"padding:12px 16px;color:#374151\">DCIS or LCIS, with mastectomy as definitive treatment<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Z15.01<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Genetic susceptibility to malignant neoplasm of breast<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Prophylactic mastectomy in BRCA1 or BRCA2 carriers<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">N60.x<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Benign mammary dysplasia<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Uncommon, and only where benign disease causes real symptoms<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Z80.3<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Family history of malignant neoplasm of breast<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Supporting risk context, never the primary indication<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<p class=\"wp-block-paragraph\">Verify the pairing against the payer&#8217;s LCD before you submit. The diagnosis then travels on an electronic claim, so the <a href=\"https:\/\/pabau.com\/blog\/hipaa-compliance-for-medical-offices\/\">HIPAA rules<\/a> covering the client record cover the claim file too.<\/p>\n\n\n\n<h2 id=\"h-breast-surgery-codes-that-sit-next-to-19303\" class=\"wp-block-heading\">Breast surgery codes that sit next to 19303<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">19303 is one code in a family, and anyone coding breast cases needs the rest of it. The <a href=\"https:\/\/www.aapc.com\/codes\/cpt-codes-range\/19300-19307\/\" target=\"_blank\" rel=\"nofollow noopener\">mastectomy range<\/a> runs from 19300 to 19307. The lymph node codes in the 38xxx range often ride along on the same claim, and the diagnostic work-up has codes of its own.<\/p>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">CPT code<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Description<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Relationship to 19304<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">19300<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Mastectomy for gynecomastia<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Male breast tissue, and not interchangeable with 19303<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\"><a href=\"https:\/\/pabau.com\/procedure-codes\/cpt-code-19302\/\">19302<\/a><\/td>\n<td style=\"padding:12px 16px;color:#374151\">Partial mastectomy with axillary lymphadenectomy<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Partial excision plus node dissection in one session<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">19303<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Mastectomy, simple, complete<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Primary replacement for the deleted 19304<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\"><a href=\"https:\/\/pabau.com\/procedure-codes\/cpt-code-19305\/\">19305<\/a><\/td>\n<td style=\"padding:12px 16px;color:#374151\">Mastectomy, radical<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Adds the pectoral muscles and the axillary nodes<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">19307<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Mastectomy, modified radical<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Adds the axillary nodes but spares pectoralis major<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\"><a href=\"https:\/\/pabau.com\/procedure-codes\/cpt-code-19125\/\">19125<\/a><\/td>\n<td style=\"padding:12px 16px;color:#374151\">Open excision of a breast lesion marked before surgery<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Diagnostic excision that often precedes a mastectomy<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\"><a href=\"https:\/\/pabau.com\/procedure-codes\/cpt-code-19284\/\">19284<\/a><\/td>\n<td style=\"padding:12px 16px;color:#374151\">Percutaneous placement of a breast localization device<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Marks the lesion before biopsy or excision<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\"><a href=\"https:\/\/pabau.com\/procedure-codes\/cpt-code-19086\/\">19086<\/a><\/td>\n<td style=\"padding:12px 16px;color:#374151\">Breast biopsy with device placement, each additional lesion<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Work-up billed well before the mastectomy claim<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">38525<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Open biopsy or excision of axillary lymph nodes<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Commonly co-billed, so check the NCCI bundling edits<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">38792<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Injection procedure for sentinel node identification<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Sentinel node mapping, and bundling varies by payer<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">38900<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Intraoperative sentinel lymph node mapping<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Add-on reported with the mastectomy in the same session<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<p class=\"wp-block-paragraph\">38525 is the one to watch. Billed alongside a mastectomy code it is frequently bundled, which means the node work is already paid inside the mastectomy payment. Unbundling it anyway is a reliable way to attract an audit. Check the current edits before you split the line.<\/p>\n\n\n\n<h2 id=\"h-how-a-19303-claim-actually-moves\" class=\"wp-block-heading\">How a 19303 claim actually moves<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">A mastectomy claim passes five checkpoints between the operating room and the remittance. Knowing which one catches a deleted code saves a lot of guessing.<\/p>\n\n\n\n<ol class=\"wp-block-list\">\n<li><strong>The operative note closes.<\/strong> The surgeon records the side, the tissue removed, and what was preserved. Everything downstream leans on this.<\/li>\n\n\n\n<li><strong>The coder assigns the line.<\/strong> 19303 goes on with LT, RT, or 50, plus the diagnosis matching the indication.<\/li>\n\n\n\n<li><strong>The biller checks insurer fields.<\/strong> Membership number, authorization number, and place of service. A blank field here bounces the claim before anyone reviews it.<\/li>\n\n\n\n<li><strong>The clearinghouse scrubs it.<\/strong> Format and code-validity edits run first, which is exactly where a live 19304 gets caught.<\/li>\n\n\n\n<li><strong>The payer adjudicates.<\/strong> NCCI edits, medical necessity, and the LCD all apply, and the remittance names whichever one failed.<\/li>\n<\/ol>\n\n\n\n<p class=\"wp-block-paragraph\">Most of the delay sits in steps three and four. Both are catchable inside the practice, which is why the short check below is worth building into your routine.<\/p>\n\n\n\n<h3 id=\"h-run-this-check-before-you-submit\" class=\"wp-block-heading\">Run this check before you submit<\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li>19304 is gone from the charge master, the superbill, and the note templates.<\/li>\n\n\n\n<li>The claim line reads 19303 with LT, RT, or modifier 50, in the form the payer wants.<\/li>\n\n\n\n<li>The diagnosis matches the indication, so C50.x or D05.x for therapeutic, Z15.01 for prophylactic.<\/li>\n\n\n\n<li>The operative report is signed and names the side, the tissue removed, and the structures preserved.<\/li>\n\n\n\n<li>Membership number and authorization number are both filled in.<\/li>\n\n\n\n<li>Node codes have been checked against the current NCCI edits.<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Three mistakes account for most of the rework. Billing 19304 for a current date of service is the obvious one. The quiet one is 19303 billed bilaterally when the payer wants two lateral lines. The slow one is a note that never records skin and nipple status, and that surfaces months later in a records request.<\/p>\n\n\n        <div id=\"pro_tip\">\n            <div class=\"img\">\n                <svg width=\"42\" height=\"42\" viewBox=\"0 0 42 42\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                    <path fill-rule=\"evenodd\" clip-rule=\"evenodd\"\n                        d=\"M12.6383 19.5238C12.6632 21.2071 12.8734 22.9926 12.0685 24.5523C11.0341 26.8917 8.45076 28.169 7.56292 30.5918C6.63082 33.1061 7.19505 36.185 9.31371 37.9786C10.929 39.5678 13.4183 39.9873 15.6061 39.5463C17.4592 39.073 19.1049 37.8388 19.9706 36.1608C20.781 34.7141 20.7866 32.9904 20.5293 31.3985C20.1006 29.3092 18.3775 27.8705 16.9807 26.362C14.8814 24.1005 14.6684 20.6854 15.595 17.8915C16.4331 15.4768 19.0026 14.2344 20.0425 11.9461C20.7202 10.6769 20.7506 9.20327 20.6068 7.81304C20.1864 5.40098 18.3139 3.23631 15.8716 2.56674C13.9742 2.03969 11.8224 2.30052 10.1739 3.37614C8.70522 4.34688 7.5878 5.86618 7.28356 7.58178C6.76081 9.82981 7.53525 12.2822 9.20307 13.9118C10.7658 15.4741 12.4806 17.2273 12.6383 19.5238Z\"\n                        fill=\"#2BADD4\" \/>\n                    <path fill-rule=\"evenodd\" clip-rule=\"evenodd\"\n                        d=\"M22.7048 19.8387C22.6822 22.3279 24.4507 24.6234 26.7493 25.4682C28.0531 25.961 29.4725 25.9183 30.7989 25.5487C32.0575 24.9955 33.301 24.2237 34.0069 23.0092C34.8384 21.5811 35.2982 19.8286 34.7832 18.2094C34.3611 16.2507 32.8739 14.6541 31.0275 13.9426C28.6736 12.9595 25.8073 13.7942 24.1719 15.7001C23.2022 16.8366 22.6143 18.3326 22.7048 19.8387Z\"\n                        fill=\"#2BADD4\" \/>\n                <\/svg>\n            <\/div>\n            <div class=\"text\">\n                <h3>Pro Tip<\/h3>\n                <p>Ask your clearinghouse for its rejection report, not only the payer denial report. A deleted code usually fails the clearinghouse scrub, so those claims never reach the payer and never appear in a denial list. They can sit unnoticed for months.<\/p>\n            <\/div>\n        <\/div>\n    \n\n\n<h2 id=\"h-what-the-operative-report-has-to-say\" class=\"wp-block-heading\">What the operative report has to say<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Moving to 19303 does not lighten the documentation load. It raises it. The code describes total removal of the gland, so your note has to explain why the skin is still there. Five elements make a clean claim.<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Operative report:<\/strong> Name the procedure, the side, the tissue removed, and the structures preserved.<\/li>\n\n\n\n<li><strong>Indication statement:<\/strong> Say whether the surgery was therapeutic, with C50.x or D05.x, or prophylactic, with Z15.01.<\/li>\n\n\n\n<li><strong>Pathology report:<\/strong> Therapeutic cases need one confirming malignant or pre-malignant tissue. Payers ask for it during medical necessity review.<\/li>\n\n\n\n<li><strong>Skin and NAC status:<\/strong> Skin preservation is what separated the old 19304 from a total mastectomy. Say plainly what was kept.<\/li>\n\n\n\n<li><strong>Surgeon&#8217;s signature:<\/strong> An unsigned operative report is one of the most common triggers for a post-payment clawback.<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">A template that asks for laterality, tissue extent, and indication while the surgeon is still in the note beats any retrospective addendum. <a href=\"https:\/\/pabau.com\/features\/patient-intake-software\/\">Digital forms<\/a> in your practice management system can carry that structure and make those fields required. Good <a href=\"https:\/\/pabau.com\/blog\/medical-forms-at-your-healthcare-practice\/\">medical documentation<\/a> habits cost far less than an audit response.<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" src=\"https:\/\/cdn.pabau.com\/cdn\/attachments\/pulse\/content-engine\/billing_codes\/cpt-code-19304\/digital-forms.webp\" alt=\"Pabau medical form builder showing a template library and a mobile form preview\"\/><figcaption class=\"wp-element-caption\"><em>Pabau&#8217;s form builder turns your operative checklist into a template, so laterality and tissue removed get recorded every time.<\/em><\/figcaption><\/figure>\n\n\n\n<div style=\"height:35px;width:800px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<h2 id=\"h-how-to-clear-19304-out-of-your-system\" class=\"wp-block-heading\">How to clear 19304 out of your system<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Denials from a deleted code are entirely preventable. Five steps clear it, and they apply to any practice performing these operations without having fully switched over.<\/p>\n\n\n\n<ol class=\"wp-block-list\">\n<li><strong>Audit the charge master.<\/strong> Search for 19304 in your charge description master. If it is still active, deactivate it and map it to 19303 with a note about the modifier rules. Then run a report on pending claims to catch any that already carry it.<\/li>\n\n\n\n<li><strong>Update the superbill.<\/strong> Paper superbills and electronic encounter forms listing 19304 need the line replaced. Add a short note for billing staff about bilateral cases.<\/li>\n\n\n\n<li><strong>Update templates and order sets.<\/strong> Procedure templates and pre-populated billing fields referencing 19304 all need correcting. Your EHR administrator or <a href=\"https:\/\/pabau.com\/blog\/practice-management-software\/\">practice management software<\/a> team can push the change once, centrally.<\/li>\n\n\n\n<li><strong>Brief the coders.<\/strong> They need the ACS guidance, the modifier framework for bilateral cases, and the ICD-10 pairing rules. A 15-minute internal session prevents a year of repeat errors.<\/li>\n\n\n\n<li><strong>Work the denial report.<\/strong> Pull every claim denied for 19304, then resubmit with 19303 and the right modifier. Timely filing usually runs 90 to 180 days from the date of service or the denial, so this step expires.<\/li>\n<\/ol>\n\n\n\n<p class=\"wp-block-paragraph\">A shared code library helps here, because one correction reaches every template at once. Checking each superbill and encounter form by hand is slower and easier to get wrong. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\">That matters most for <a href=\"https:\/\/pabau.com\/industry\/plastic-surgery-emr\/\">plastic surgery practices<\/a> and <a href=\"https:\/\/pabau.com\/industry\/obgyn-emr-software\/\">women&#8217;s health practices<\/a> running breast cases alongside everything else.<\/p>\n\n\n\n<h2 id=\"h-how-pabau-stops-an-incomplete-claim-from-going-out\" class=\"wp-block-heading\">How Pabau stops an incomplete claim from going out<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Plenty of denied mastectomy claims have nothing wrong with the coding. The membership number is blank, or the authorization number never made it onto the claim. It still goes out, sits with the payer for three weeks, then comes back for rework.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Practice management software like Pabau closes that route off. Pabau&#8217;s <a href=\"https:\/\/pabau.com\/features\/claims-management-software\/\">claims management software<\/a> validates the fields an insurer requires before anything is sent, including membership numbers and authorization codes. If one is missing, Send stays disabled until someone fills it in. The claim cannot leave in a state the payer can reject on a technicality.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The documentation sits in the same place. Treatment notes and digital forms capture laterality, the tissue removed, and the indication while the surgeon is still writing. When a payer asks for the operative report, it is already attached to the record holding the invoice and the claim. Nobody hunts through a shared drive for it.<\/p>\n\n\n        <div id=\"book_a_demo\">\n            <div class=\"left-side\">\n                <div class=\"logo\">\n                    <img decoding=\"async\"\n                        src=\"https:\/\/pabau.com\/wp-content\/uploads\/2026\/01\/Logo.svg\"\n                        alt=\"Logo\"\n                        loading=\"lazy\"\n                    \/>\n                <\/div>\n\n                <h3 class=\"heading\">\n                    Send claims that pass the payer&#8217;s first check                <\/h3>\n\n                <p class=\"description\">\n                    Pabau&#8217;s claims management software validates the insurer fields a claim needs, such as membership and authorization numbers, before it sends. Send stays disabled until the record is complete, so fewer claims come back as rejections.                <\/p>\n\n                <div class=\"button-group\">\n                    <a href=\"\/book-demo\/\" class=\"btn btn-scale-effect btn-cta-color btn-md\">\n                        <span class=\"btn-text\">Book a demo<\/span>\n                        <div class=\"btn-icon btn-icon-right\" aria-hidden=\"true\">\n                            <svg\n                                width=\"14\"\n                                height=\"12\"\n                                viewBox=\"0 0 14 12\"\n                                fill=\"none\"\n                                xmlns=\"http:\/\/www.w3.org\/2000\/svg\"\n                            >\n                                <path\n                                    d=\"M0.75 4.77295C0.335786 4.77295 0 5.10874 0 5.52295C0 5.93716 0.335786 6.27295 0.75 6.27295V5.52295V4.77295ZM13.2803 6.05328C13.5732 5.76039 13.5732 5.28551 13.2803 4.99262L8.50736 0.219648C8.21447 -0.073245 7.73959 -0.073245 7.4467 0.219648C7.15381 0.512542 7.15381 0.987415 7.4467 1.28031L11.6893 5.52295L7.4467 9.76559C7.15381 10.0585 7.15381 10.5334 7.4467 10.8263C7.73959 11.1191 8.21447 11.1191 8.50736 10.8263L13.2803 6.05328ZM0.75 5.52295V6.27295L12.75 6.27295V5.52295V4.77295L0.75 4.77295V5.52295Z\"\n                                    fill=\"currentColor\"\n                                ><\/path>\n                            <\/svg>\n                        <\/div>\n                    <\/a>\n                <\/div>\n            <\/div>\n\n            <div class=\"right-side\">\n                <img decoding=\"async\"\n                    src=\"https:\/\/pabau.com\/wp-content\/uploads\/2026\/01\/Home-Page-Concept-4.webp\"\n                    alt=\"Pabau practice management dashboard\"\n                    loading=\"lazy\"\n                \/>\n            <\/div>\n        <\/div>\n        \n\n\n<h2 id=\"h-conclusion\" class=\"wp-block-heading\">Conclusion<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Treat 19304 as an archive entry and nothing more. Every current mastectomy of this type goes out under 19303, with the laterality modifier the payer prefers and a note that says what was preserved. That part is settled.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">What is still open is your own system. If 19304 is live anywhere in your charge master, superbill, or templates, the denials are already happening and nobody has traced them yet. An hour spent auditing the code list pays for itself in one recovered claim. Your denial report will tell you how many are still inside the filing window.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Cleaning the code list stops the old denials. Catching incomplete claims stops the next batch. <a href=\"https:\/\/pabau.com\/book-demo\/\">Book a demo<\/a> to see how Pabau validates insurer fields on a claim before it leaves your practice.<\/p>\n\n\n        <div id=\"expert_picks\">\n            <div class=\"header\">\n                                    <img decoding=\"async\" src=\"https:\/\/pabau.com\/wp-content\/uploads\/2025\/11\/Expert-Picks.svg\" alt=\"Continue your research\" height=\"42\" width=\"42\">\n                                <h3>Continue your research<\/h3>\n            <\/div>\n            <div class=\"content\">\n                                                            <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#54B2D3\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p><strong>Need to justify a prophylactic mastectomy to a payer?<\/strong> <a href=\"https:\/\/pabau.com\/templates\/medical-necessity-letter\/\">Medical necessity letter<\/a> gives you a structure for the clinical argument a reviewer wants to read.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#54B2D3\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p><strong>Handling a records request after a mastectomy claim?<\/strong> <a href=\"https:\/\/pabau.com\/templates\/medicare-consent-to-release-form\/\">Medicare consent to release form<\/a> covers the authorization you need before releasing an operative report.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#54B2D3\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p><strong>Billing staff handling claim files every day?<\/strong> <a href=\"https:\/\/pabau.com\/blog\/hipaa-training-for-employees\/\">HIPAA training for employees<\/a> sets out what your team has to know before they touch patient data.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#54B2D3\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p><strong>Worried about where clinical and financial records live?<\/strong> <a href=\"https:\/\/pabau.com\/blog\/patient-data-security-tools\/\">Patient data security tools<\/a> walks through the controls that keep both sets of records protected.<\/p>\n                        <\/div>\n                                                <\/div>\n        <\/div>\n    \n\n\n<h2 id=\"h-frequently-asked-questions\" class=\"wp-block-heading\">Frequently asked questions<\/h2>\n\n\n\n<div class=\"schema-faq wp-block-yoast-faq-block\"><div class=\"schema-faq-section\" id=\"faq-question-1786622214764\"><h3 class=\"schema-faq-question\">Can I still bill 19304 for an older date of service?<\/h3> <p class=\"schema-faq-answer\">Payers adjudicate a claim against the code set that was active on the date of service. A surgery performed while 19304 was still valid stays valid on a corrected claim. Anything on or after the deletion date goes out as 19303.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1786622214765\"><h3 class=\"schema-faq-question\">Is gynecomastia surgery billed with 19303?<\/h3> <p class=\"schema-faq-answer\">No. Male breast tissue removed for gynecomastia is reported with 19300, not 19303. The two are not interchangeable, and without documentation supporting a complete mastectomy a reviewer will expect 19300.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1786622214766\"><h3 class=\"schema-faq-question\">Do skin-sparing and nipple-sparing mastectomies use the same code?<\/h3> <p class=\"schema-faq-answer\">Yes. Both remove the whole gland, so both report 19303. The difference lives in the operative note, which records whether the nipple-areola complex was preserved.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1786622214767\"><h3 class=\"schema-faq-question\">Does 19303 include the breast reconstruction?<\/h3> <p class=\"schema-faq-answer\">No. Reconstruction has its own codes and is reported separately from the mastectomy. If a plastic surgeon performs it during the same session, that surgeon bills their own procedure line.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1786622214768\"><h3 class=\"schema-faq-question\">What if my payer&#8217;s fee schedule still lists 19304?<\/h3> <p class=\"schema-faq-answer\">Treat it as a stale file rather than permission to bill. Fee schedule tools keep deleted entries for historical lookups. Ask the payer for the 19303 rate in writing before you rely on it for contracting.<\/p> <\/div> <\/div>\n","protected":false},"excerpt":{"rendered":"<p>CPT code 19304 is deleted, so any claim carrying it is denied. See which code replaces it, the modifiers to use, and how to clear it from billing. Read more.<\/p>\n","protected":false},"author":85,"featured_media":178951,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_yoast_wpseo_linkdex":"80","_yoast_wpseo_content_score":"90","_yoast_wpseo_is_cornerstone":"","_yoast_wpseo_keywordsynonyms":"[\"\",\"\",\"\",\"\",\"\",\"\"]","_yoast_wpseo_focuskw_text_input":"","_seo_original_html":"","footnotes":""},"categories":[1433,1546],"tags":[],"class_list":["post-178953","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-billing-codes","category-cpt-codes"],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v28.2 (Yoast SEO v28.2) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>CPT code 19304: Why it&#039;s deleted and what to bill now<\/title>\n<meta name=\"description\" content=\"What replaced CPT code 19304? Get the new code, right modifiers, and how to clear it from your billing system.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/pabau.com\/de\/procedure-codes\/cpt-code-19304\/\" \/>\n<meta property=\"og:locale\" content=\"de_DE\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"CPT code 19304: Why it&#039;s deleted and what to bill now\" \/>\n<meta property=\"og:description\" content=\"What replaced CPT code 19304? Get the new code, right modifiers, and how to clear it from your billing system.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/pabau.com\/de\/procedure-codes\/cpt-code-19304\/\" \/>\n<meta property=\"og:site_name\" content=\"Pabau\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/Pabau\/\" \/>\n<meta property=\"article:published_time\" content=\"2026-08-14T13:36:46+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2026-08-14T14:38:32+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/pabau.com\/wp-content\/uploads\/2026\/08\/cpt-code-19304.webp\" \/>\n\t<meta property=\"og:image:width\" content=\"1200\" \/>\n\t<meta property=\"og:image:height\" content=\"630\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/webp\" \/>\n<meta name=\"author\" content=\"Monika Lazarevska\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:creator\" content=\"@pabaucrm\" \/>\n<meta name=\"twitter:site\" content=\"@pabaucrm\" \/>\n<meta name=\"twitter:label1\" content=\"Verfasst von\" \/>\n\t<meta name=\"twitter:data1\" content=\"Monika Lazarevska\" \/>\n\t<meta name=\"twitter:label2\" content=\"Gesch\u00e4tzte Lesezeit\" \/>\n\t<meta name=\"twitter:data2\" content=\"13\u00a0Minuten\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/pabau.com\\\/de\\\/procedure-codes\\\/cpt-code-19304\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/pabau.com\\\/de\\\/procedure-codes\\\/cpt-code-19304\\\/\"},\"author\":{\"name\":\"Monika Lazarevska\",\"@id\":\"https:\\\/\\\/pabau.com\\\/de\\\/#\\\/schema\\\/person\\\/5763062f66fccbf75a390f99ee0b985a\"},\"headline\":\"CPT code 19304: Why it&#8217;s deleted and what to bill now\",\"datePublished\":\"2026-08-14T13:36:46+00:00\",\"dateModified\":\"2026-08-14T14:38:32+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/pabau.com\\\/de\\\/procedure-codes\\\/cpt-code-19304\\\/\"},\"wordCount\":2592,\"publisher\":{\"@id\":\"https:\\\/\\\/pabau.com\\\/de\\\/#organization\"},\"image\":{\"@id\":\"https:\\\/\\\/pabau.com\\\/de\\\/procedure-codes\\\/cpt-code-19304\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/pabau.com\\\/wp-content\\\/uploads\\\/2026\\\/08\\\/cpt-code-19304.webp\",\"articleSection\":[\"Billing Codes\",\"CPT Codes\"],\"inLanguage\":\"de\"},{\"@type\":[\"WebPage\",\"FAQPage\"],\"@id\":\"https:\\\/\\\/pabau.com\\\/de\\\/procedure-codes\\\/cpt-code-19304\\\/\",\"url\":\"https:\\\/\\\/pabau.com\\\/de\\\/procedure-codes\\\/cpt-code-19304\\\/\",\"name\":\"CPT code 19304: Why it's deleted and what to bill now\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/pabau.com\\\/de\\\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\\\/\\\/pabau.com\\\/de\\\/procedure-codes\\\/cpt-code-19304\\\/#primaryimage\"},\"image\":{\"@id\":\"https:\\\/\\\/pabau.com\\\/de\\\/procedure-codes\\\/cpt-code-19304\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/pabau.com\\\/wp-content\\\/uploads\\\/2026\\\/08\\\/cpt-code-19304.webp\",\"datePublished\":\"2026-08-14T13:36:46+00:00\",\"dateModified\":\"2026-08-14T14:38:32+00:00\",\"description\":\"What replaced CPT code 19304? Get the new code, right modifiers, and how to clear it from your billing system.\",\"mainEntity\":[{\"@id\":\"https:\\\/\\\/pabau.com\\\/de\\\/procedure-codes\\\/cpt-code-19304\\\/#faq-question-1786622214764\"},{\"@id\":\"https:\\\/\\\/pabau.com\\\/de\\\/procedure-codes\\\/cpt-code-19304\\\/#faq-question-1786622214765\"},{\"@id\":\"https:\\\/\\\/pabau.com\\\/de\\\/procedure-codes\\\/cpt-code-19304\\\/#faq-question-1786622214766\"},{\"@id\":\"https:\\\/\\\/pabau.com\\\/de\\\/procedure-codes\\\/cpt-code-19304\\\/#faq-question-1786622214767\"},{\"@id\":\"https:\\\/\\\/pabau.com\\\/de\\\/procedure-codes\\\/cpt-code-19304\\\/#faq-question-1786622214768\"}],\"inLanguage\":\"de\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\\\/\\\/pabau.com\\\/de\\\/procedure-codes\\\/cpt-code-19304\\\/\"]}]},{\"@type\":\"ImageObject\",\"inLanguage\":\"de\",\"@id\":\"https:\\\/\\\/pabau.com\\\/de\\\/procedure-codes\\\/cpt-code-19304\\\/#primaryimage\",\"url\":\"https:\\\/\\\/pabau.com\\\/wp-content\\\/uploads\\\/2026\\\/08\\\/cpt-code-19304.webp\",\"contentUrl\":\"https:\\\/\\\/pabau.com\\\/wp-content\\\/uploads\\\/2026\\\/08\\\/cpt-code-19304.webp\",\"width\":1200,\"height\":630},{\"@type\":\"WebSite\",\"@id\":\"https:\\\/\\\/pabau.com\\\/de\\\/#website\",\"url\":\"https:\\\/\\\/pabau.com\\\/de\\\/\",\"name\":\"Pabau\",\"description\":\"Clinic Software for your Business | Go Paperless Today\",\"publisher\":{\"@id\":\"https:\\\/\\\/pabau.com\\\/de\\\/#organization\"},\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\\\/\\\/pabau.com\\\/de\\\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"de\"},{\"@type\":\"Organization\",\"@id\":\"https:\\\/\\\/pabau.com\\\/de\\\/#organization\",\"name\":\"Pabau\",\"url\":\"https:\\\/\\\/pabau.com\\\/de\\\/\",\"logo\":{\"@type\":\"ImageObject\",\"inLanguage\":\"de\",\"@id\":\"https:\\\/\\\/pabau.com\\\/de\\\/#\\\/schema\\\/logo\\\/image\\\/\",\"url\":\"https:\\\/\\\/pabau.com\\\/wp-content\\\/uploads\\\/2022\\\/05\\\/Logo-4-e1654525062364.png\",\"contentUrl\":\"https:\\\/\\\/pabau.com\\\/wp-content\\\/uploads\\\/2022\\\/05\\\/Logo-4-e1654525062364.png\",\"width\":736,\"height\":195,\"caption\":\"Pabau\"},\"image\":{\"@id\":\"https:\\\/\\\/pabau.com\\\/de\\\/#\\\/schema\\\/logo\\\/image\\\/\"},\"sameAs\":[\"https:\\\/\\\/www.facebook.com\\\/Pabau\\\/\",\"https:\\\/\\\/x.com\\\/pabaucrm\",\"https:\\\/\\\/www.linkedin.com\\\/company\\\/pabau-ltd\\\/\",\"https:\\\/\\\/www.instagram.com\\\/pabausoftware\\\/\"],\"description\":\"Pabau is an all-in-one healthcare practice management software platform designed for clinics, medspas, therapists, and medical professionals. It combines scheduling, electronic health records, clinical forms, payments, marketing automation, reporting, and patient engagement tools into one secure cloud system to help practices streamline operations and grow their business.\",\"foundingDate\":\"2011-10-20\",\"numberOfEmployees\":{\"@type\":\"QuantitativeValue\",\"minValue\":\"201\",\"maxValue\":\"500\"}},{\"@type\":\"Person\",\"@id\":\"https:\\\/\\\/pabau.com\\\/de\\\/#\\\/schema\\\/person\\\/5763062f66fccbf75a390f99ee0b985a\",\"name\":\"Monika Lazarevska\",\"image\":{\"@type\":\"ImageObject\",\"inLanguage\":\"de\",\"@id\":\"https:\\\/\\\/pabau.com\\\/wp-content\\\/uploads\\\/2026\\\/07\\\/cropped-Monika-Lazarevska-skala-2-1-e1783430903842-1-96x96.jpg\",\"url\":\"https:\\\/\\\/pabau.com\\\/wp-content\\\/uploads\\\/2026\\\/07\\\/cropped-Monika-Lazarevska-skala-2-1-e1783430903842-1-96x96.jpg\",\"contentUrl\":\"https:\\\/\\\/pabau.com\\\/wp-content\\\/uploads\\\/2026\\\/07\\\/cropped-Monika-Lazarevska-skala-2-1-e1783430903842-1-96x96.jpg\",\"caption\":\"Monika Lazarevska\"},\"description\":\"Monika Lazarevska writes content for owners and healthcare professionals who want clear, no-fluff content that actually helps them run their practice better. With a background in storytelling and SEO, she knows how to make even the driest topics worth reading. Off the clock, you'll find her in a caf\u00e9 somewhere in Europe, probably with a good book and an even better coffee.\",\"url\":\"https:\\\/\\\/pabau.com\\\/de\\\/blog\\\/author\\\/monika-lazarevska\\\/\"},{\"@type\":\"Question\",\"@id\":\"https:\\\/\\\/pabau.com\\\/de\\\/procedure-codes\\\/cpt-code-19304\\\/#faq-question-1786622214764\",\"position\":1,\"url\":\"https:\\\/\\\/pabau.com\\\/de\\\/procedure-codes\\\/cpt-code-19304\\\/#faq-question-1786622214764\",\"name\":\"Can I still bill 19304 for an older date of service?\",\"answerCount\":1,\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"Payers adjudicate a claim against the code set that was active on the date of service. A surgery performed while 19304 was still valid stays valid on a corrected claim. Anything on or after the deletion date goes out as 19303.\",\"inLanguage\":\"de\"},\"inLanguage\":\"de\"},{\"@type\":\"Question\",\"@id\":\"https:\\\/\\\/pabau.com\\\/de\\\/procedure-codes\\\/cpt-code-19304\\\/#faq-question-1786622214765\",\"position\":2,\"url\":\"https:\\\/\\\/pabau.com\\\/de\\\/procedure-codes\\\/cpt-code-19304\\\/#faq-question-1786622214765\",\"name\":\"Is gynecomastia surgery billed with 19303?\",\"answerCount\":1,\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"No. Male breast tissue removed for gynecomastia is reported with 19300, not 19303. The two are not interchangeable, and without documentation supporting a complete mastectomy a reviewer will expect 19300.\",\"inLanguage\":\"de\"},\"inLanguage\":\"de\"},{\"@type\":\"Question\",\"@id\":\"https:\\\/\\\/pabau.com\\\/de\\\/procedure-codes\\\/cpt-code-19304\\\/#faq-question-1786622214766\",\"position\":3,\"url\":\"https:\\\/\\\/pabau.com\\\/de\\\/procedure-codes\\\/cpt-code-19304\\\/#faq-question-1786622214766\",\"name\":\"Do skin-sparing and nipple-sparing mastectomies use the same code?\",\"answerCount\":1,\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"Yes. Both remove the whole gland, so both report 19303. The difference lives in the operative note, which records whether the nipple-areola complex was preserved.\",\"inLanguage\":\"de\"},\"inLanguage\":\"de\"},{\"@type\":\"Question\",\"@id\":\"https:\\\/\\\/pabau.com\\\/de\\\/procedure-codes\\\/cpt-code-19304\\\/#faq-question-1786622214767\",\"position\":4,\"url\":\"https:\\\/\\\/pabau.com\\\/de\\\/procedure-codes\\\/cpt-code-19304\\\/#faq-question-1786622214767\",\"name\":\"Does 19303 include the breast reconstruction?\",\"answerCount\":1,\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"No. Reconstruction has its own codes and is reported separately from the mastectomy. If a plastic surgeon performs it during the same session, that surgeon bills their own procedure line.\",\"inLanguage\":\"de\"},\"inLanguage\":\"de\"},{\"@type\":\"Question\",\"@id\":\"https:\\\/\\\/pabau.com\\\/de\\\/procedure-codes\\\/cpt-code-19304\\\/#faq-question-1786622214768\",\"position\":5,\"url\":\"https:\\\/\\\/pabau.com\\\/de\\\/procedure-codes\\\/cpt-code-19304\\\/#faq-question-1786622214768\",\"name\":\"What if my payer's fee schedule still lists 19304?\",\"answerCount\":1,\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"Treat it as a stale file rather than permission to bill. Fee schedule tools keep deleted entries for historical lookups. Ask the payer for the 19303 rate in writing before you rely on it for contracting.\",\"inLanguage\":\"de\"},\"inLanguage\":\"de\"}]}<\/script>\n<!-- \/ Yoast SEO Premium plugin. -->","yoast_head_json":{"title":"CPT code 19304: Why it's deleted and what to bill now","description":"What replaced CPT code 19304? Get the new code, right modifiers, and how to clear it from your billing system.","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/pabau.com\/de\/procedure-codes\/cpt-code-19304\/","og_locale":"de_DE","og_type":"article","og_title":"CPT code 19304: Why it's deleted and what to bill now","og_description":"What replaced CPT code 19304? Get the new code, right modifiers, and how to clear it from your billing system.","og_url":"https:\/\/pabau.com\/de\/procedure-codes\/cpt-code-19304\/","og_site_name":"Pabau","article_publisher":"https:\/\/www.facebook.com\/Pabau\/","article_published_time":"2026-08-14T13:36:46+00:00","article_modified_time":"2026-08-14T14:38:32+00:00","og_image":[{"width":1200,"height":630,"url":"https:\/\/pabau.com\/wp-content\/uploads\/2026\/08\/cpt-code-19304.webp","type":"image\/webp"}],"author":"Monika Lazarevska","twitter_card":"summary_large_image","twitter_creator":"@pabaucrm","twitter_site":"@pabaucrm","twitter_misc":{"Verfasst von":"Monika Lazarevska","Gesch\u00e4tzte Lesezeit":"13\u00a0Minuten"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"Article","@id":"https:\/\/pabau.com\/de\/procedure-codes\/cpt-code-19304\/#article","isPartOf":{"@id":"https:\/\/pabau.com\/de\/procedure-codes\/cpt-code-19304\/"},"author":{"name":"Monika Lazarevska","@id":"https:\/\/pabau.com\/de\/#\/schema\/person\/5763062f66fccbf75a390f99ee0b985a"},"headline":"CPT code 19304: Why it&#8217;s deleted and what to bill now","datePublished":"2026-08-14T13:36:46+00:00","dateModified":"2026-08-14T14:38:32+00:00","mainEntityOfPage":{"@id":"https:\/\/pabau.com\/de\/procedure-codes\/cpt-code-19304\/"},"wordCount":2592,"publisher":{"@id":"https:\/\/pabau.com\/de\/#organization"},"image":{"@id":"https:\/\/pabau.com\/de\/procedure-codes\/cpt-code-19304\/#primaryimage"},"thumbnailUrl":"https:\/\/pabau.com\/wp-content\/uploads\/2026\/08\/cpt-code-19304.webp","articleSection":["Billing Codes","CPT Codes"],"inLanguage":"de"},{"@type":["WebPage","FAQPage"],"@id":"https:\/\/pabau.com\/de\/procedure-codes\/cpt-code-19304\/","url":"https:\/\/pabau.com\/de\/procedure-codes\/cpt-code-19304\/","name":"CPT code 19304: Why it's deleted and what to bill now","isPartOf":{"@id":"https:\/\/pabau.com\/de\/#website"},"primaryImageOfPage":{"@id":"https:\/\/pabau.com\/de\/procedure-codes\/cpt-code-19304\/#primaryimage"},"image":{"@id":"https:\/\/pabau.com\/de\/procedure-codes\/cpt-code-19304\/#primaryimage"},"thumbnailUrl":"https:\/\/pabau.com\/wp-content\/uploads\/2026\/08\/cpt-code-19304.webp","datePublished":"2026-08-14T13:36:46+00:00","dateModified":"2026-08-14T14:38:32+00:00","description":"What replaced CPT code 19304? Get the new code, right modifiers, and how to clear it from your billing system.","mainEntity":[{"@id":"https:\/\/pabau.com\/de\/procedure-codes\/cpt-code-19304\/#faq-question-1786622214764"},{"@id":"https:\/\/pabau.com\/de\/procedure-codes\/cpt-code-19304\/#faq-question-1786622214765"},{"@id":"https:\/\/pabau.com\/de\/procedure-codes\/cpt-code-19304\/#faq-question-1786622214766"},{"@id":"https:\/\/pabau.com\/de\/procedure-codes\/cpt-code-19304\/#faq-question-1786622214767"},{"@id":"https:\/\/pabau.com\/de\/procedure-codes\/cpt-code-19304\/#faq-question-1786622214768"}],"inLanguage":"de","potentialAction":[{"@type":"ReadAction","target":["https:\/\/pabau.com\/de\/procedure-codes\/cpt-code-19304\/"]}]},{"@type":"ImageObject","inLanguage":"de","@id":"https:\/\/pabau.com\/de\/procedure-codes\/cpt-code-19304\/#primaryimage","url":"https:\/\/pabau.com\/wp-content\/uploads\/2026\/08\/cpt-code-19304.webp","contentUrl":"https:\/\/pabau.com\/wp-content\/uploads\/2026\/08\/cpt-code-19304.webp","width":1200,"height":630},{"@type":"WebSite","@id":"https:\/\/pabau.com\/de\/#website","url":"https:\/\/pabau.com\/de\/","name":"Pabau","description":"Clinic Software for your Business | Go Paperless Today","publisher":{"@id":"https:\/\/pabau.com\/de\/#organization"},"potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/pabau.com\/de\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"de"},{"@type":"Organization","@id":"https:\/\/pabau.com\/de\/#organization","name":"Pabau","url":"https:\/\/pabau.com\/de\/","logo":{"@type":"ImageObject","inLanguage":"de","@id":"https:\/\/pabau.com\/de\/#\/schema\/logo\/image\/","url":"https:\/\/pabau.com\/wp-content\/uploads\/2022\/05\/Logo-4-e1654525062364.png","contentUrl":"https:\/\/pabau.com\/wp-content\/uploads\/2022\/05\/Logo-4-e1654525062364.png","width":736,"height":195,"caption":"Pabau"},"image":{"@id":"https:\/\/pabau.com\/de\/#\/schema\/logo\/image\/"},"sameAs":["https:\/\/www.facebook.com\/Pabau\/","https:\/\/x.com\/pabaucrm","https:\/\/www.linkedin.com\/company\/pabau-ltd\/","https:\/\/www.instagram.com\/pabausoftware\/"],"description":"Pabau is an all-in-one healthcare practice management software platform designed for clinics, medspas, therapists, and medical professionals. It combines scheduling, electronic health records, clinical forms, payments, marketing automation, reporting, and patient engagement tools into one secure cloud system to help practices streamline operations and grow their business.","foundingDate":"2011-10-20","numberOfEmployees":{"@type":"QuantitativeValue","minValue":"201","maxValue":"500"}},{"@type":"Person","@id":"https:\/\/pabau.com\/de\/#\/schema\/person\/5763062f66fccbf75a390f99ee0b985a","name":"Monika Lazarevska","image":{"@type":"ImageObject","inLanguage":"de","@id":"https:\/\/pabau.com\/wp-content\/uploads\/2026\/07\/cropped-Monika-Lazarevska-skala-2-1-e1783430903842-1-96x96.jpg","url":"https:\/\/pabau.com\/wp-content\/uploads\/2026\/07\/cropped-Monika-Lazarevska-skala-2-1-e1783430903842-1-96x96.jpg","contentUrl":"https:\/\/pabau.com\/wp-content\/uploads\/2026\/07\/cropped-Monika-Lazarevska-skala-2-1-e1783430903842-1-96x96.jpg","caption":"Monika Lazarevska"},"description":"Monika Lazarevska writes content for owners and healthcare professionals who want clear, no-fluff content that actually helps them run their practice better. With a background in storytelling and SEO, she knows how to make even the driest topics worth reading. Off the clock, you'll find her in a caf\u00e9 somewhere in Europe, probably with a good book and an even better coffee.","url":"https:\/\/pabau.com\/de\/blog\/author\/monika-lazarevska\/"},{"@type":"Question","@id":"https:\/\/pabau.com\/de\/procedure-codes\/cpt-code-19304\/#faq-question-1786622214764","position":1,"url":"https:\/\/pabau.com\/de\/procedure-codes\/cpt-code-19304\/#faq-question-1786622214764","name":"Can I still bill 19304 for an older date of service?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"Payers adjudicate a claim against the code set that was active on the date of service. A surgery performed while 19304 was still valid stays valid on a corrected claim. Anything on or after the deletion date goes out as 19303.","inLanguage":"de"},"inLanguage":"de"},{"@type":"Question","@id":"https:\/\/pabau.com\/de\/procedure-codes\/cpt-code-19304\/#faq-question-1786622214765","position":2,"url":"https:\/\/pabau.com\/de\/procedure-codes\/cpt-code-19304\/#faq-question-1786622214765","name":"Is gynecomastia surgery billed with 19303?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"No. Male breast tissue removed for gynecomastia is reported with 19300, not 19303. The two are not interchangeable, and without documentation supporting a complete mastectomy a reviewer will expect 19300.","inLanguage":"de"},"inLanguage":"de"},{"@type":"Question","@id":"https:\/\/pabau.com\/de\/procedure-codes\/cpt-code-19304\/#faq-question-1786622214766","position":3,"url":"https:\/\/pabau.com\/de\/procedure-codes\/cpt-code-19304\/#faq-question-1786622214766","name":"Do skin-sparing and nipple-sparing mastectomies use the same code?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"Yes. Both remove the whole gland, so both report 19303. The difference lives in the operative note, which records whether the nipple-areola complex was preserved.","inLanguage":"de"},"inLanguage":"de"},{"@type":"Question","@id":"https:\/\/pabau.com\/de\/procedure-codes\/cpt-code-19304\/#faq-question-1786622214767","position":4,"url":"https:\/\/pabau.com\/de\/procedure-codes\/cpt-code-19304\/#faq-question-1786622214767","name":"Does 19303 include the breast reconstruction?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"No. Reconstruction has its own codes and is reported separately from the mastectomy. If a plastic surgeon performs it during the same session, that surgeon bills their own procedure line.","inLanguage":"de"},"inLanguage":"de"},{"@type":"Question","@id":"https:\/\/pabau.com\/de\/procedure-codes\/cpt-code-19304\/#faq-question-1786622214768","position":5,"url":"https:\/\/pabau.com\/de\/procedure-codes\/cpt-code-19304\/#faq-question-1786622214768","name":"What if my payer's fee schedule still lists 19304?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"Treat it as a stale file rather than permission to bill. Fee schedule tools keep deleted entries for historical lookups. Ask the payer for the 19303 rate in writing before you rely on it for contracting.","inLanguage":"de"},"inLanguage":"de"}]}},"yoast":{"focus_keyword":"CPT Code 19304","seo_title":"CPT code 19304: Why it's deleted and what to bill now","meta_description":"What replaced CPT code 19304? Get the new code, right modifiers, and how to clear it from your billing system.","content_score":"90","is_cornerstone":"","related_keyphrases":[{"keyword":"mastectomy cpt code","score":61},{"keyword":"cpt code 19303","score":61},{"keyword":"breast surgery cpt codes","score":61},{"keyword":"cpt code modifiers","score":61},{"keyword":"coding mastectomy procedures","score":61}]},"_links":{"self":[{"href":"https:\/\/pabau.com\/de\/wp-json\/wp\/v2\/posts\/178953","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/pabau.com\/de\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/pabau.com\/de\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/pabau.com\/de\/wp-json\/wp\/v2\/users\/85"}],"replies":[{"embeddable":true,"href":"https:\/\/pabau.com\/de\/wp-json\/wp\/v2\/comments?post=178953"}],"version-history":[{"count":3,"href":"https:\/\/pabau.com\/de\/wp-json\/wp\/v2\/posts\/178953\/revisions"}],"predecessor-version":[{"id":180773,"href":"https:\/\/pabau.com\/de\/wp-json\/wp\/v2\/posts\/178953\/revisions\/180773"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/pabau.com\/de\/wp-json\/wp\/v2\/media\/178951"}],"wp:attachment":[{"href":"https:\/\/pabau.com\/de\/wp-json\/wp\/v2\/media?parent=178953"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/pabau.com\/de\/wp-json\/wp\/v2\/categories?post=178953"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/pabau.com\/de\/wp-json\/wp\/v2\/tags?post=178953"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}