Wiki Breast Reconstruction-Fat Injection by Liposuction

[Denises]

Patient had a mastectomy then a DIEP Flap reconstruction (S2068). Patient then comes back for a breast revision in addition to fat injections. Fat is obtained via liposuction.

Is it correct to report CPT procedure codes 11954 (for the fat injection) and CPT procedure code 20926 (for fat that was obtained via liposuction for the fat injection) in addition to the breast revision (CPT procedure code 19380)?

I just want to make sure 11954 and 20926 are correct.

Thank you for your thoughts on this issue.
Denise

 

[sundaey]

fat injections for breast reconstruction

One of my plastic surgeons does this quite frequently. I've used 15877, because he does use a cannula and performs a lipectomy, then uses a centrifuge to separate the fat and oil, and injects the pure fat into the deformities. Based on the amount (per CC's) I would use codes 11952-11954. Hope this helps.

 

[surgonc87]

19380

 

[sundaey]

Why would you use 19380? There was no mention of cutting into the patient's breast at all.

 

[plasticscoder]

I would report CPT 19380 [revision reconstructed breast] for fat injections. The intended purpose of this procedure is to 'revise' the shape or correct deformity when tissues have settled post reconstruction by TRAM, latiss, expander, implant, etc. I would also bill CPT 20926 to report the fat harvest/preparation. Although direct incisions may not be made into the breast, CPT 19380 is the only breast code available that closest describes the procedure performed [adding tissue to revise the shape of the breast]. Request that your surgeon be as detailed as possible dictating the way s/he injects the fat, amount injected, sutures the injection sites, and manual techniques utilized to revise the shape. CPTs 11950-11954 should be reported when injections are made using 'shelf-type' filling material [i.e. collagen, juvederm, etc.] Historically many payers have denied the injection codes as 'cosmetic in nature' or 'experimental.' So if you decide to bill 11950-11954, keep an eye on reimbursement trends.