Wiki revision of reconstructed breast

[dbykov]

Doctor did revision of reconstruction breast with removal of tissue expander,
capsulectomy and placement of permanent implant.
I find CPT 19371 and 19380, but CPT 11971-Removal of tissue expander without insertion of prosthesis.
Is another code for removal of breast tissue expander or is it included in
CPT 19371 AND 19380 ? Thanks.

 

[lavanyamohan]

Doctor did revision of reconstruction breast with removal of tissue expander,
capsulectomy and placement of permanent implant.
I find CPT 19371 and 19380, but CPT 11971-Removal of tissue expander without insertion of prosthesis.
Is another code for removal of breast tissue expander or is it included in
CPT 19371 AND 19380 ? Thanks.

Reply-
Coding 19380 is appropriate.

 

[FTessaBartels]

Not 11971

The description of CPT 11971 gives you the answer ... "without insertion of prosthesis." Your implant is the prosthesis in this case. So you would NOT use this code in thei scenario.

F Tessa Bartels, CPC

 

[Mashlady1]

Breast Tissue Expanders

Thank you for having this question on the site. A patient is going to have
her tissue expanders removed, and replaced with pernament implants.
And this question led me to the 11970. The breast code series 19000's
lacks real specifics for the amount of breast procedures done now.
Thank again, Mashlady1

 

[Kevinph84]

Agreed!

I couldn't agree any more with you. The AMA needs to make adjustments to the breast reconstruction codes. We need more specific codes or more information in which the current codes cover. I have been working in the ASC setting for one year now, and these cases (revision of breast reconstruction) still can stump me!

 

[kdhecb1]

Question 11971

If 11971 was performed bilaterally can we list code more than once. It is unclear. I do see expander(s). I do want to code correctly. Anybody have any insight?

Dr. removed bilateral tissue expanders without insertion of breast implants.

Thank you,

Kimberly Hollins, CPC, CPRC