Wiki Breast reconstruction? Complete total capsulectomy along with skin/fat excision

klbecker

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I have a provider who is performing a Bilateral breast implant removal with bilateral complete capsulectomy along with Bilateral breast, skin and fat excess excision with Layered closure.

The patient has a history of breast cancer, has undergone a mastectomy followed by tissue expander, then breast implant placement for breast reconstruction. They now have capsular contracture and would like to have the implants removed. The patient also has excess skin and fat of the chest wall, this will be excised, along with complete capsulectomy, to improve the symmetry of her reconstruction. I'm looking at 19371 for the complete capsulectomy and 19380 for the excess skin and fat excision. But there is a NCCI edit for the 19371 into the 19380. Would it be correct to add a 59 modifier onto the 19371? 19380 includes revision to the capsule, but does that revision include complete capsulectomy?
 
you would be able to over ride the edit with mod 59 if this was individual breast; but...since this is a bilateral procedure I am thinking you would code just the 19380-50. Hope this helps!
 
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