# 19350 with 15130?  Nipple Reconstruction



## nsteinhauser (Nov 5, 2009)

Hi everyone.  I'm trying to figure out if I can code separately for dermal grafts used during a nipple reconstruction.  I am using 19350.  And in the description in cpt, it says the physician excises graft skin, etc., but it makes no mention if the graft can be coded separately.  I checked the CPT Assistant references in the skin grafts and other integmentary codes and in the breast codes (lots of info) but it never addresses this specific question that I can find.  I would use 15130 if it was ok to code separately.

If anyone out there knows the answer, I'd sure appreciate it.  Thanks!


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## surgonc87 (Nov 6, 2009)

We do not report the skin graft in our office, just the nipple reconstruction code.


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## Bella Cullen (Nov 10, 2009)

I used to bill full thickness and split thickness skin grafts separate with 19350.I never billed for dermal but I think it would be billable sep.


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## tinaboe (Dec 2, 2009)

*Tinaboe*

Hello,

There is an article in the CPT Corner put out by the American Society of Plastic Surgeons which states...

19350 is the global code for nipple-areolar reconstruction. It includes the formation of the nipple mound by any of the various flap methods, as well as the creation of the areola with a skin graft.
To code separately for the flap (14000) and the graft (15200) is unbundling, as 19350 includes both the flap and the graft. If anything less than a flap and graft is done, then the "reduced services" modifier, "-52," should be used to indicate that only a portion of the procedure was
performed.

So with this being said - I do not code separately for the grafts.


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## RebeccaWoodward* (Aug 19, 2010)

tinaboe said:


> Hello,
> 
> There is an article in the CPT Corner put out by the American Society of Plastic Surgeons which states...
> 
> ...



Does anyone, by chance, have a copy of this article?


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