Wiki Lumpectomy, help with breast surgery.

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Alta

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The surgeon terms it Lumpectomy with sentinel node sampling reconstructed with lateral advancement flaps. My question is on the lateral advancement flaps closure. It is taking breast tissue itself from below and then closure with sutures. Is this just included? There is no code in the repair/reconstruction in cpt that matches this, so I am thinking this is just considered part of the whole operation and not separately coded? Help, please, thank you!
 
What about code 15734? It's not bundled with code 19302. I would want to read the op report to be sure, and do a little more digging, but this is what came to mind.

Melissa-CPC
 
I do lots of breast surgery coding and for your case, I code them using cpt 14000-14001 since in the description it states: "codes 14000-14300 are used for excision (including lesion) and/or repair by adjacent tissue transfer or rearrangement (eg, z-plasty, w-plasty, v-y plasty, rotation flap, advancement flap, double pedicle flap.)

also depending on the OP it could be 19301+38525 OR 19302(when the lymphadenectomy is done via a separate incision!)

hope this helps!:D
 
Hi there,

Are you getting paid for the advancement flap coding? I recently had two Anthem claims come back denied for 14001 stating it was included in the primary procedure (19301). Coding for the advancement flaps in addition to the lumpectomy is new to me, so far the Anthem denials are the only that I am aware of.

Thanks for your help. :)
 
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