breast reconstruction

  1. N

    Wiki Breast revision and implant replacement

    Hello- My surgeon wants to bill 19380 with 19342. When I ran it thru NCCI edits, it edited out. But in the CPT guidelines, it states to report 19342 separately. Do I bill it with a 59 modifier? For some reason, that just doesn't feel right. Any input? Thank you for any and all input. Deb
  2. N

    Wiki Oncoplastic Reshaping After Lumpectomy - Breast Reduction with Nipple Graft

    Hi There! I am hoping someone can help me correctly code this procedure. We came up with 19318-50, 13101 and 13102 but I'm not sure since the Oncoplastic portion was only done on one breast. PREOPERATIVE DIAGNOSIS: Left breast neoplasm. POSTOPERATIVE DIAGNOSIS: Left breast neoplasm...
    • noellenoble
    • Thread
    • breast reconstruction breast reduction breast surgery lumpectomy oncoplastic
    • Replies: 1
    • Forum: Plastic Surgery
  3. V

    Wiki 19342

    Aetna breast cancer patient had delayed reconstruction so the doctor inserted bilateral implants. I coded 19342 with modifier 50 and aetna only paid for one side, do i need to bill with rt and lt modifiers to receive proper reimbursement? Bcbs pays with modifier 50. We don't have many aetna...
  4. A

    Wiki Breast reconstruction operative report needed

    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.
    • ADV
    • Thread
    • breast reconstruction flap operative report
    • Replies: 1
    • Forum: Plastic Surgery
  5. K

    Wiki 20926

    Can anyone tell me what codes be coded with 20926? If you have an article to support the list, it would be greatly appreciated. There is a lot of discussion in our PS office about breast procedures and 20926 being used together.
    • kweese
    • Thread
    • 20926 breast reconstruction plastic sugery
    • Replies: 1
    • Forum: Plastic Surgery
  6. M

    Wiki Bilateral Breast Reconstruction with acellular dermal tissue matrix

    We are a plastic surgery practice whose surgeon often performs bilateral placement of tissue expanders in immediate breast reconstruction. He will also place acellular dermal tissue matrices at the time of the expansion (CPT code 15777, an add-on code). We typically bill 19357-50 and 15777-50...
  7. D

    Wiki 19499 is being denied to 19357

    Has anyone heard of medical insurances paying on both 19357 and 19499 in the same operative session. I am having Medicare, UHC and BCBS that are denying the 19499 as included in 19357. I see don't see anywhere that 19499 is global to 19357. Please Help!
  8. V

    Wiki Breast Reconstruction - reviewed Medicare

    Hello everyone, I work for a Plastic and Reconstructive Surgeon in Birmingham, MI. We just reviewed Medicare CCI edits and it is including 14301 (adjacent tissue transfers) in the breast reconstruction codes along with 15734. Our practice is primarily breast cancer patients, so these bundled...
  9. P

    Wiki Help Coding an advanced flap and lysis of adhesions Breast

    I need help coding an advanced flap on a revision of reconstructed breast and Lysis of pectoralis fascia adhesion's. Dr. doesn't specify size at all for flap so I thought to use 14000 and for the adhesion's there is no Lysis code for this so I thought to use incision code for 11300 since again...
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