Wiki T/E replaced with Perm Implants

[idjimenez]

I know the correct code to use is 11970 for the replacement of tissue expanders with perm implants. But, would you also code 19340 - Immediate insertion of breast prothesis? I checked the Ingenix coding edits, and unless I'm looking in the wrong place, they do not show as being bundled with one another. Any advise would be a great help!

Thanks!

 

[nsteinhauser]

No - you would just use the 11970. From CPT Assistant August 2005:

If a temporary tissue expander has been used, it is removed after the skin has stretched sufficiently and replaced with a permanent breast prosthesis during a second operation. This procedure is generally coded 11970, Replacement of tissue expander with permanent prosthesis. Code 11970 is global and includes removal of the temporary expander, which is not to be reported separately. In certain instances, considerable capsular adjustments are necessary to allow proper placement of the prosthesis within the fibrous capsule that has formed around the expander, and with appropriate documentation in the operative report, code 19342 is sometimes used instead of 11970.

Hope this helps.