Summary & Overview
CPT 3374F: Breast Cancer Stage I, Tumor T1c
CPT code 3374F denotes documentation that a female patient (age 18+) has breast cancer staged as stage I, T1c (tumor >1 cm to ≤2 cm). This code captures a specific clinical staging detail used in oncology records and quality measurement to indicate early-stage invasive disease with a defined tumor size range. Nationally, structured staging documentation supports treatment planning, registry reporting, and performance measurement for cancer care quality.
Key payers addressed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of the clinical context for staging the T1c tumor category, typical settings where this documentation is recorded, and the role of this code in clinical documentation and quality programs. The publication outlines benchmarks and policy-relevant considerations tied to documentation completeness and coding consistency, and it highlights implications for registry submission and care coordination. Data not available in the input is noted where applicable for payer-specific edits, modifiers, taxonomies, ICD-10 pairings, and related billing codes.
Billing Code Overview
CPT code 3374F documents a clinician diagnosis of breast cancer in a female patient aged 18 years or older and specifies stage I, subclassification T1c, indicating a tumor greater than 1 cm but less than or equal to 2 cm in greatest dimension.
Service type: oncology diagnostic and staging documentation.
Typical site of service: outpatient oncology clinic or hospital outpatient setting, where diagnostic workup, pathology review, and staging documentation occur.
Clinical & Coding Specifications
Clinical Context
A 52-year-old female presents to a multidisciplinary breast clinic after an abnormal screening mammogram and diagnostic ultrasound that identified a 1.6 cm irregular enhancing mass in the left breast. Core needle biopsy confirms invasive ductal carcinoma. The treating breast surgical oncologist documents pathologic staging as Stage I, subclassification T1c (tumor >1 cm and ≤2 cm), node-negative, hormone receptor status positive, HER2-negative. The clinical workflow includes preoperative counseling, pathology confirmation of size and margins, breast-conserving surgery or mastectomy discussion, sentinel lymph node biopsy, and coordination with medical and radiation oncology for adjuvant therapy planning. Imaging, pathology, operative notes, and staging documentation are entered into the medical record to support the 3374F billing statement that documents the patient as female ≥18 years with breast cancer staged I, T1c. Payor communications and prior authorization for surgery or systemic therapy are completed by the clinic team.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
25 | Significant, separately identifiable evaluation and management service by the same physician on the same day of procedure | Use when a distinct E/M visit is performed the same day as a breast procedure if documentation supports separate work |