Summary & Overview

CPT 0352T: OCT Margin Assessment for Excised Breast Tissue

CPT code 0352T covers optical coherence tomography (OCT) imaging used for intraoperative assessment of surgical margins in excised breast tissue and axillary lymph nodes, with subsequent interpretation and reporting. This procedure matters nationally because it offers real-time feedback during breast cancer surgery that can reduce re-excision rates, improve surgical planning, and potentially influence downstream care and costs. Payers addressed in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.

Readers will find a concise explanation of the clinical application of 0352T, the typical settings where it is performed, and the operational implications for surgical teams and radiology services. The publication summarizes common modifiers associated with the service and identifies where data are available or missing. It also outlines what to expect in payer coverage patterns, documentation requirements, and reporting practices nationally. Clinical context provided clarifies how OCT margin assessment fits into breast-conserving surgery workflows and postoperative reporting. Policy and reimbursement highlights focus on the code’s role in enabling intraoperative decision-making and the potential impact on utilization and quality metrics. Data not available in the input are clearly noted where applicable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare0352TCPToptical coherence tomographybreast surgeryintraoperative imagingmargin assessmentradiologysurgical oncology

Billing Code Overview

CPT code 0352T describes the use of optical coherence tomography (OCT) imaging to detect cancer cells in the margins of excised breast tissue or axillary lymph nodes. The procedure provides the surgeon with immediate intraoperative feedback about whether surgical margins are clear of cancer cells or whether additional tissue excision is needed. After the surgical procedure, the imaging data are interpreted and reported by the operating provider or a radiologist.

Service type: Intraoperative margin assessment using optical coherence tomography with post-procedure interpretation and reporting

Typical site of service: Operating room or surgical suite (intraoperative) with post-procedure interpretation in a clinical or radiology setting

Clinical & Coding Specifications

Clinical Context

A typical patient is a woman undergoing breast-conserving surgery (lumpectomy) for a diagnosed or suspected malignant breast tumor. The patient has preoperative imaging and a core needle biopsy confirming invasive carcinoma or ductal carcinoma in situ. Intraoperatively, after excision of the tumor and surrounding margin tissue (or an excised axillary lymph node), the surgical team requests immediate optical coherence tomography (OCT) specimen imaging to evaluate margin status. A trained provider (surgeon or intraoperative imaging specialist) or a radiologist performs 0352T imaging in the operating room or an adjacent pathology/imaging suite while the patient remains under anesthesia. The OCT device provides near–real-time imaging of specimen margins; results inform whether additional tissue resection is required during the same operation to achieve clear margins.

Postoperatively, either the operating surgeon or a radiologist interprets and documents the OCT findings in the operative note and final pathology correlation. Typical documentation includes indication for intraoperative margin assessment, specimen identifier, imaging findings specifying margin status, and any immediate re-excision performed based on the OCT results. The procedure is commonly performed at an ambulatory surgical center, hospital operating room, or integrated surgical suite with immediate access to pathology and imaging support.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	Use when work required is substantially greater than typical (e.g., extensive imaging interpretation or unusually complex specimen handling).
`23`	Unusual anesthesia	Use when general anesthesia is required for a procedure that normally uses local/regional anesthesia (rare for breast excision with OCT if anesthesia is atypical).
`52`	Reduced services	Use when OCT imaging is performed but is partially completed or limited in scope.
`53`	Discontinued procedure	Use when OCT imaging is started but discontinued due to patient instability or intraoperative complication.
`62`	Two surgeons	Use when a second surgeon is required for the operation and both share in the work related to specimen imaging or re-excision decisions.
`AS`	Ambulatory surgical center facility	Use to indicate the service was provided in an ambulatory surgical center setting.
`CO`	Catastrophic injury related to worker’s comp	Use per payer rules when service is related to a catastrophic work-related injury claim (payer-specific reporting).
`CQ`	Service furnished by physician not in the network	Use to identify a service furnished by an out-of-network professional under certain payer policies.
`QK`	Medical direction of two–three assistants	Use when the primary surgeon medically directs two or three assistants during the operation involving specimen imaging/re-excision.
`QX`	CRNA services with physician present	Use when a certified registered nurse anesthetist provides anesthesia with the physician present, if anesthesia coding is relevant to the same operative episode.
`QY`	Medical direction of one CRNA	Use when the physician medically directs one CRNA during the procedure.
`SH`	Physician service - assistant at surgery	Use when a qualified physician assistant acts as an assistant at surgery for the case involving OCT-guided margins.
`SJ`	Non-physician practitioner assistant at surgery	Use when a non-physician practitioner (nurse practitioner or physician assistant) assists and billing rules require this modifier.

Taxonomy Code	Specialty	Notes
207Q00000X	General Surgery	Surgeons performing lumpectomy and intraoperative margin assessment.
207XS0100X	Surgical Oncology	Specialists in oncologic breast surgery who commonly use intraoperative imaging for margin assessment.
207K00000X	Obstetrics & Gynecology (Breast Surgery focus)	Some breast surgeons with OB/GYN primary taxonomy perform lumpectomies in certain practices.
207L00000X	Plastic Surgery	May be involved for oncoplastic resections and immediate reconstruction decisions informed by margin status.
2084P0800X	Diagnostic Radiology	Radiologists who may perform or interpret OCT imaging of specimens intra- or postoperatively.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`C50.912`	Malignant neoplasm of unspecified site of right female breast	Common primary diagnosis for which lumpectomy and intraoperative margin assessment with `0352T` is performed.
`C50.911`	Malignant neoplasm of unspecified site of left female breast	As above, for left-sided breast cancer requiring excision and margin evaluation.
`D05.90`	Unspecified carcinoma in situ of breast	Carcinoma in situ often treated with breast-conserving surgery where OCT may be used to confirm clear margins.
`C77.3`	Secondary and unspecified malignant neoplasm of axillary and upper limb lymph nodes	Indicates nodal involvement; excised nodes may be imaged or assessed in conjunction with OCT-guided specimen evaluation.
`N63`	Unspecified lump in breast	Diagnostic indication for excision of a suspicious mass where intraoperative OCT can assist margin assessment when malignancy is found.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`19301`	Partial mastectomy, lumpectomy, or excision of breast tumor (single lesion)	Primary surgical procedure during which `0352T` OCT specimen imaging is frequently performed to assess margins intraoperatively.
`38525`	Biopsy or excision of lymph node(s); open, deep axillary node sampling	Axillary node procedures performed during the same operative session; OCT may be used on excised nodes to assess involvement or margin.
`88305`	Level IV surgical pathology, gross and microscopic examination	Final histopathology of the specimen that confirms and correlates with intraoperative OCT findings; reported postoperatively.
`88342`	Immunohistochemistry, per specimen; initial single antibody stain	Utilized in definitive pathology to subtype tumor and assess margins when OCT findings prompt additional analysis.
`76942`	Ultrasonic guidance for needle placement	May be used preoperatively for localization of nonpalpable lesions before excision and subsequent OCT margin assessment.
`77046`	Magnetic resonance imaging, breast, per breast, including CAD when performed	Preoperative imaging that may inform the surgical approach where intraoperative OCT is later used for margin evaluation.