19364

CPT^® 19364, Under Repair and/or Reconstruction Procedures on the Breast

The Current Procedural Terminology (CPT^®) code 19364 as maintained by American Medical Association, is a medical procedural code under the range - Repair and/or Reconstruction Procedures on the Breast.

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Summary

The provider artificially creates the contour of a breast by harvesting a free flap of skin and muscle and/or fat from another site such as the inner thigh, buttock, or lower abdomen and suturing it at the site of the breast to restore cosmetic appearance following a modified or radical mastectomy, or to repair a defect.

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Lateral Intercostal Artery Perforator Flap

19364 is a free flap. 19361 I feel would be more appropriate with modifier 52 as the flap does not include muscle traditionally (only skin and fat) and comes from the side of the chest rather than the... [ Read More ]

Lateral Intercostal Artery Perforator Flap

Wondering if anyone has code this type of breast reconstruction? Thinking of coding with CPT code 19364. Thoughts? Patient had lumpectomy and radiation but no prior reconstruction so I don't believe... [ Read More ]

Breast reconstruction; TRAM w/co surgeon (19364) 19364 co-surgeon

I did a search on procedure code 19364 for this thread and it looks like this question goes way back. We have had a few insurance companies deny the co-surgeons (62 modifier) for procedure code 1936... [ Read More ]

Coding Surgical Prep Codes with DEIP Flap??

My surgeon wants to code surgical prep codes (15002) when doing DEIP flaps - I have never heard of doing this. There isn't a CCI edit, they can be coded together, but I feel like the code 19364 covers... [ Read More ]

Failed DIEP Breast Reconstruction free flap

Patients initial surgery was a Removal of bilateral silicone implants using DIEP free flap. The patient was brought back to the operating room 4 days later for an exploration with thrombectomy and rev... [ Read More ]

coder

I am stuck on a claim and I was hoping you could help me. there were 2 co-surgeons (mod 62) on a DIEP reconstruction (19364) but it failed and had to do reconstruction with tissue expander (19357). I... [ Read More ]

Breast reconstruction operative report needed breast reconstruction flap operative report

Does anyone have an operative report detailing code 19364 Breast reconstruction with free flap? I'm doing some training and don't have one available.... [ Read More ]

DIEP Flap 19364 vs S2068

So my phys has negotiated with some insurance companies using S2068 for a higher payout vs 19364. My question is on a recent DIEP procedure, a certain ins company paid out $3700 for the entire procedu... [ Read More ]

S2068 and modifier 62

[b]S2068 and Tricare[/b] We were able to obtain reimbursement using S2068, including the assistant and cosurgeon. However, effective Feb 2016 Tricare has posted a No Pay List which is now excluding ... [ Read More ]

S2068 and modifier 62

[b]S2068 and modifier[/b] Maria, Have you been able to bill an assistant surgeon with the S2068 code yet?? If not, are you using the 19364 or just not charging for an assist? We are having this s... [ Read More ]

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