Oncology & Hematology Coding Alert

Reader Question:

Look to This LCD for Breast Reconstruction Necessity

Question: I billed 19318-RT for symmetry with 19361-LT for breast cancer and absence of breast. Medicare denied it, so I appealed. The appeal was unfavorable stating the 19318 was cosmetic. Is there another code we need to be using when the reduction is done for symmetry? It doesn’t seem right that the doctor is not entitled to reimbursement for this. AAPC [...]
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