CPT code 19112 denotes surgical excision of a fistula connecting a lactiferous (milk) duct to the skin. This targeted breast surgical procedure is clinically relevant for patients with persistent duct-skin fistulas that can cause drainage, recurrent infection, or pain. Nationally, accurate coding of 19112 supports appropriate clinical documentation and claims processing for breast-conserving surgical management.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the code’s clinical scope, typical sites of service, and where 19112 fits within breast surgical care. The discussion highlights typical billing considerations, common modifiers used with surgical codes, and areas where documentation affects coverage and payment decisions.

This publication provides benchmarks and policy context relevant to hospitals and ambulatory surgery centers, along with clinical context for surgeons and coding teams. It outlines what counts as the service described by 19112 and what information payers commonly require for adjudication. Data not available in the input will be noted where applicable.