19370

CPT^® 19370, Under Repair and/or Reconstruction Procedures on the Breast

The Current Procedural Terminology (CPT^®) code 19370 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

In this procedure, the provider surgically releases a capsule, or the scar tissue, that forms within the breast tissue around a previous implant. The provider performs this procedure to relieve pain from the contraction of the scar tissue or to address malpositioning of the breast implant.

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View matching HCPCS Level II codes and their definitions.

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Question about CPT Codes

CPT 11970 for the removal of tissue expanders w/replacement of perm breast implant. And, per CPT assist from September 2021 FAQ's, you may report 11970 with 19370 if extensive revisions to capsule ar... [ Read More ]

Question about CPT Codes

I have a surgery that needs billed out for Tissue expanders being removed from the Breasts and Breast implants placed. According to the 2020 CPT book it says to use the 19342 with a 50 modifier for Bi... [ Read More ]

Unbundling of CPT 19370 with 11970

Hello there anyone.... I work in Plastic Surgery and have a Mastectomy Reconstruction Coding Question; Anyone know how to unbundle CPT 19370 (Repair & Reconstruction on the Breast) with CPT 11970 ( Re... [ Read More ]

Breast Recon

11970-RT exhange of expander with implant 19370 might need a modifier(XU) for the RT capsulotomy per the CPT guidance this may be billed if revision is required for implant, extensive capular revisio... [ Read More ]

11970 and 19370 being bundled by several insurance companies. Anyone else?

On 2nd and 3rd breast reconstruction cases, we are finding that 11970 is being bundled with the 19370. I'm seeing this with some insurance companies. Does anyone have a suggestion on how to bill diffe... [ Read More ]

19342 & 19371

CPT 19371 is for a complete capsulectomy and includes the removal of all intracapsular contents. It cannot be assigned with 19328 and 19370, but 19342 can be reported separately for replacement of a n... [ Read More ]

Does code 19380 include capsulotomy?

I'm using cpt code 19380 for a revision to bilateral reconstructed breasts where a capsulorrhaphy is done to elevate the inframammary fold. Would 19380 also include cpt code 19370 (capsulotomy)? Or is... [ Read More ]

Medicare Denial: MA130-CLM IS UNPROCSSBLE, SBMT NEW CLM/

I'm not strong in this specialty, but it appears to me you're billing a bilateral primary procedure and then using an XU modifier to indicate a separate procedure, but then the XU modifier can't be su... [ Read More ]

Medicare Denial: MA130-CLM IS UNPROCSSBLE, SBMT NEW CLM/

Medicare Denial: MA130-CLM IS UNPROCSSBLE, SBMT NEW CLM and 4-PX INCONS W/ MODIF/REQD MODIF MISSNG CPT/Modifiers 19370 Modifiers 78,50,XU 19328 Modifiers 78,50,XU 19342 Modifiers 78,50 Dx: C50.111 Pa... [ Read More ]

Breast Reconstruction Help

[QUOTE="lnaschke, post: 445510, member: 28784"]I am having a lot of claims denied for breast recontruction. Below is a typical Claim 19342-50 19370-50,59 19301-50,59 And the notes... "She had inf... [ Read More ]

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