Wiki Free Nipple Graft with Gynecomastia surgery

[TnRushFan]

Good morning, I have been researching this and cannot find a definitive answer.
Any thoughts are greatly appreciated.

My surgeon performed gynecomastia reduction surgery and free nipple grafting. She documented it differently this time (as skin graft) and am wondering if it will bundle into main surgery or if can capture it with skin graft codes - if not graft code possibly -22.

I have my 19300 and 15877 codes that we normally bill for gynecomastia but not sure about the nipple grafts since worded differently.

PRE-OP DIAGNOSIS: Gynecomastia
POST-OP DIAGNOSIS: Gynecomastia
PROCEDURE: Bilateral Double incision Mastectomy with Free Nipple Grafting

We began the procedure by marking a 3cm x 2.5 cm border around the nipple
areolar complex and harvesting them bilaterally as full thickness skin grafts.
They were placed in moist towels and put on the back table...
<documents removed breast tissue
<documents performed liposuction
...Following this, we used our NAC template and de-epithelized a 3cm x 2.5cm area
in which to place our nipple graft. The graft was secured with interrupted 4-0
chromic and a xeroform bolster placed and secured with silk suture. Sterile
dressings were placed.

 

[nyckimmie]

Hello, Unfortunately, I don't have an answer only the same question. Coders are using unlisted 19499, as 3M encoder is leading there (graft, nipple= 19499). Doesn't seem right since a code exists for full thickness graft (15200) or nipple reconstruction (19350). If any one has a suggestion of how to code19300 w/a free nipple grafting, I would appreciate any assistance. Thank you.

 

[sinman0531]

Good morning, I have been researching this and cannot find a definitive answer.
Any thoughts are greatly appreciated.

My surgeon performed gynecomastia reduction surgery and free nipple grafting. She documented it differently this time (as skin graft) and am wondering if it will bundle into main surgery or if can capture it with skin graft codes - if not graft code possibly -22.

I have my 19300 and 15877 codes that we normally bill for gynecomastia but not sure about the nipple grafts since worded differently.

PRE-OP DIAGNOSIS: Gynecomastia
POST-OP DIAGNOSIS: Gynecomastia
PROCEDURE: Bilateral Double incision Mastectomy with Free Nipple Grafting

We began the procedure by marking a 3cm x 2.5 cm border around the nipple
areolar complex and harvesting them bilaterally as full thickness skin grafts.
They were placed in moist towels and put on the back table...
<documents removed breast tissue
<documents performed liposuction
...Following this, we used our NAC template and de-epithelized a 3cm x 2.5cm area
in which to place our nipple graft. The graft was secured with interrupted 4-0
chromic and a xeroform bolster placed and secured with silk suture. Sterile
dressings were placed.

Well, per the AMA it is considered inclusive to bill 15200 with 19318, even if you do free nipple grafting....so by that extension 15200 is acceptable for free nipple grafts.