Wiki Goldilocks breast reconstruction

[BJROBERTS]

One of my providers performed a nipple sparing mastectomy followed by a Goldilocks pedicle flap breast reconstruction. I am trying to find the appropriate CPT code for this procedure, any suggestions? So far I have only been able to find information on the technique used and the recommended ICD-10PCS code. Any help with this would be greatly appreciated.

 

[narredondo1103@gmail.com]

From what I am reading in the header of the CPT book, It look as if the 19303 is the code to use.

 

[BJROBERTS]

From what I am reading in the header of the CPT book, It look as if the 19303 is the code to use.

Thank you for your response, I do agree that the 19303 is appropriate for the mastectomy part of the procedure but I am looking for the appropriate code for the reconstruction. It is a technigue utilizing pedicle flaps to form a small breast mound.

 

[MI_CODER]

Mastectomy with Goldilocks reconstruction
Coding Clinic for HCPCS - Second Quarter 2021 Page: 10 Effective Date: May 26, 2021

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QUESTION 10
A patient with left breast cancer presented for bilateral skin and nipple sparing mastectomies with Goldilocks reconstruction. After the removal of the breast tissue, dermal autografts/flaps were created and tacked superomedially to create breast mounds. The medial inferior dermal flap was tacked on the pectoralis muscle in the upper inner quadrant and the lateral inferior dermal flap was tacked on the pectoralis in the central portion of the pectoralis muscle. The edges were brought together with staples creating small breast mounds consisting of dermal graft under the mastectomy incision prior to closing the mastectomy flaps. What is the correct code assignment for a mastectomy with Goldilocks reconstruction?

ANSWER
Assign CPT code 19303, Mastectomy, simple, complete, with modifier 50, Bilateral Procedure, for the bilateral mastectomies. Assign CPT code 14000, Adjacent tissue transfer or rearrangement, trunk; defect 10 sq cm or less, or code 14001, Adjacent tissue transfer or rearrangement, trunk; defect 10.1 sq cm to 30.0 sq cm, with the number of units of CPT code 14001 based on the documented square centimeters, for the reconstruction. In a Goldilocks reconstruction, redundant mastectomy flap tissue is utilized to create a breast mound and the technique may be captured with an adjacent tissue transfer code.

 

[BJROBERTS]

Mastectomy with Goldilocks reconstruction
Coding Clinic for HCPCS - Second Quarter 2021 Page: 10 Effective Date: May 26, 2021

ASK THE EDITOR

QUESTION 10
A patient with left breast cancer presented for bilateral skin and nipple sparing mastectomies with Goldilocks reconstruction. After the removal of the breast tissue, dermal autografts/flaps were created and tacked superomedially to create breast mounds. The medial inferior dermal flap was tacked on the pectoralis muscle in the upper inner quadrant and the lateral inferior dermal flap was tacked on the pectoralis in the central portion of the pectoralis muscle. The edges were brought together with staples creating small breast mounds consisting of dermal graft under the mastectomy incision prior to closing the mastectomy flaps. What is the correct code assignment for a mastectomy with Goldilocks reconstruction?

ANSWER
Assign CPT code 19303, Mastectomy, simple, complete, with modifier 50, Bilateral Procedure, for the bilateral mastectomies. Assign CPT code 14000, Adjacent tissue transfer or rearrangement, trunk; defect 10 sq cm or less, or code 14001, Adjacent tissue transfer or rearrangement, trunk; defect 10.1 sq cm to 30.0 sq cm, with the number of units of CPT code 14001 based on the documented square centimeters, for the reconstruction. In a Goldilocks reconstruction, redundant mastectomy flap tissue is utilized to create a breast mound and the technique may be captured with an adjacent tissue transfer code.

Thank you, your response is very much appreciated.