# skin and nipple-sparing mastectomies



## cmdalton73@gmail.com (Aug 23, 2013)

Any help with this will be greatly appreciated, I'm thinking this is 19303, but the nipple-sparing is confusing me.  

Thanks for any help you can offer. 

Attention was turned to the right breast, where an inferior circumareolar
incision was made with medial and lateral extensions. It was deepened
through subcutaneous tissue with Bovie cautery. Skin flaps were raised to
the clavicle, leaving the nipple areolar complex intact medial to the
sternum, inferior to the inframammary fold, lateral to the latissimus dorsi
muscle. The breast was removed off the chest wall subfascially, maintaining
hemostasis with the Bovie cautery. At the lateral border of the pectoralis
major muscle, the breast was mobilized and amputated at the level of the
axilla. The breast was oriented and sent to Pathology. All dissection
planes were hemostatic.


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## koatsj (Aug 23, 2013)

definition for 19303.....
CPT 19303

The physician removes all subcutaneous breast tissue, _with or without nipple and skin. _The physician performs a simple, complete mastectomy. The physician makes an elliptical incision around the breast that includes the tail of Spence, the extension of mammary tissue into the axillary region. The breast tissue is dissected from the pectoral fascia and sternum. The breast tissue is removed, along with a portion of skin, including the nipple. _In a modification of the simple mastectomy, skin and nipple may be spared_, but all subcutaneous breast tissue is removed. The physician ligates any bleeding vessels. A closed wound drainage catheter may be inserted and the edges of skin are approximated, sutured, and a dressing is applied.


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