kristy2
Contributor
I have a breast cancer patient who underwent bilateral mastectomy and stage 1 of her breast reconstruction 19357 (brst recon, immediate or delayed w/ tissue expander).
The patient returned to the operating room preop diag: spontaneous rupture of expander, infection of RT brst reconstruction site & partial extrusion of expander.
The surgery performed was removal of the expander, debridement of infected tissue w/ removal of the preplaced alloderm & granulation tissue along with the placement of a wound V.A.C.
The patient was admitted for observation where she received IV antibiotics.
The CPT codes provided to me by the surgeon was 11971 (removal of tissue expander w/out insertion of prosthesis) & 97606 (negative pressure wound therapy)
It is my opinion that 11971 does not accurately describe the entire procedure performed. This case appears to be unique and I can't find a CPT code (or codes) that accurately describe the entire surgery.
Would you suggest submitting 11971 with mod 22 (unusual procedural services)? Or 19499 (unlisted procedure of the breast) w/ proper documentation? Or is there another code (or codes) that would more accurately describe the procedures done?
I have never coded a surgery like this, please help…
The patient returned to the operating room preop diag: spontaneous rupture of expander, infection of RT brst reconstruction site & partial extrusion of expander.
The surgery performed was removal of the expander, debridement of infected tissue w/ removal of the preplaced alloderm & granulation tissue along with the placement of a wound V.A.C.
The patient was admitted for observation where she received IV antibiotics.
The CPT codes provided to me by the surgeon was 11971 (removal of tissue expander w/out insertion of prosthesis) & 97606 (negative pressure wound therapy)
It is my opinion that 11971 does not accurately describe the entire procedure performed. This case appears to be unique and I can't find a CPT code (or codes) that accurately describe the entire surgery.
Would you suggest submitting 11971 with mod 22 (unusual procedural services)? Or 19499 (unlisted procedure of the breast) w/ proper documentation? Or is there another code (or codes) that would more accurately describe the procedures done?
I have never coded a surgery like this, please help…
