breast reconstruction

  1. V


    Aetna breast cancer patient had delayed reconstruction so the doctor inserted bilateral implants. I coded 19342 with modifier 50 and aetna only paid for one side, do i need to bill with rt and lt modifiers to receive proper reimbursement? Bcbs pays with modifier 50. We don't have many aetna...
  2. A

    Breast reconstruction operative report needed

    Does anyone have an operative report detailing code 19364 Breast reconstruction with free flap? I'm doing some training and don't have one available.
  3. K


    Can anyone tell me what codes be coded with 20926? If you have an article to support the list, it would be greatly appreciated. There is a lot of discussion in our PS office about breast procedures and 20926 being used together.
  4. M

    Bilateral Breast Reconstruction with acellular dermal tissue matrix

    We are a plastic surgery practice whose surgeon often performs bilateral placement of tissue expanders in immediate breast reconstruction. He will also place acellular dermal tissue matrices at the time of the expansion (CPT code 15777, an add-on code). We typically bill 19357-50 and 15777-50...
  5. D

    19499 is being denied to 19357

    Has anyone heard of medical insurances paying on both 19357 and 19499 in the same operative session. I am having Medicare, UHC and BCBS that are denying the 19499 as included in 19357. I see don't see anywhere that 19499 is global to 19357. Please Help!
  6. V

    Breast Reconstruction - reviewed Medicare

    Hello everyone, I work for a Plastic and Reconstructive Surgeon in Birmingham, MI. We just reviewed Medicare CCI edits and it is including 14301 (adjacent tissue transfers) in the breast reconstruction codes along with 15734. Our practice is primarily breast cancer patients, so these bundled...
  7. P

    Help Coding an advanced flap and lysis of adhesions Breast

    I need help coding an advanced flap on a revision of reconstructed breast and Lysis of pectoralis fascia adhesion's. Dr. doesn't specify size at all for flap so I thought to use 14000 and for the adhesion's there is no Lysis code for this so I thought to use incision code for 11300 since again...