1. S

    19110 or 19120

    Any help/insights would be greatly appreciated. I am leaning towards the 19110 but we are being told to bill it as 19120. NAME OF PROCEDURE: Right breast mass and terminal duct excision. PREOPERATIVE DIAGNOSIS: Right breast periductal mastitis. POSTOPERATIVE DIAGNOSIS: Right breast periductal...
  2. S

    76641 Breast Ultrasound Female Only?

    AAPC Coder shows that 76641 is a female only CPT code. Can anyone confirm if this is correct? I have a male patient that had bilateral breast ultrasounds, I'm wondering if I would need to use 76604 for the male??
  3. S

    Help Learning Breast Surgery Coding

    Hi! I am new to coding breast surgeries and I am looking for resources that will help me. Are there any books or websites or anything that will help? I have found a few places online but some of the information I am finding can be confusing. Any help is greatly appreciated!!
  4. W

    Non-healing breast wound following Mastectomy/Reconstruction

    Patient with history of left breast cancer and a non-healing breast wound. Underwent bilateral skin sparing mastectomy with tissue expander placement a month and a half ago. She has developed an infection in her left breast and now no longer wishes to move forward with reconstruction and wants...
  5. L

    Compromised left nipple

    The patient had breast reduction surgery earlier in the day. During postop checks she was noted to have venous congestion which was worsening and did not improve with conservative measures. The patient was taken back to the OR for re-exploration: I began by removing the previous 15 French...
  6. C

    19101 or 19110

    Not sure about this code. Attention was turned to the left breast . An elliptical incision was made in the nipple of the left breast . The specimen was dissected out sharply using palpation as a guide. The specimen was not oriented and submitted to pathology. There was noted to be residual...
  7. D

    ICD-10 for DCIS breast

    Can a DCIS code (D05._ _) stand alone as a primary diagnosis or is a C-code still needed. I have a coworker who refuses to use the DCIS codes for breast. Thank you.
  8. L

    Need HCPCS code for Tissue Breast Expander

    I am needing a HCPCS code for a tissue breast expander. There is one website that says to use C1789 and then there is another website that says to use L8600. Is there anyone that has billed this product before and would know which code would be correct?
  9. L

    Need HCPCS code for Tissue Breast Expanders

    I am needing a HCPCS code for tissue breast expanders. I have found one website that says to use C1789 and one website that says to use L8600. Is there anyone that has billed this product before and knows which code to use?
  10. 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...
  11. T

    Help coding s/p lumpectomy, here for med refill

    I'm confused about principal diagnosis for this encounter in which pt comes for refill of medication, s/p lumpectomy. I've read the admonitions not to give the patient what she no longer has, but if she's still under treatment for it...?? Provider's brief note below and dx code he chose...
  12. R

    Breast mass

    What is the dx code for breast mass? Insurance won't pay for N63. Thank You,
  13. M

    Nipple revision

    Patient had nipple reconstruction. The procedure failed and patient came back in for second nipple reconstruction. Do I code for another nipple reconstruction (19350) or for revision of reconstructed breast (19380)? Any input would be greatly appreciated!
  14. M

    CPT for malposition of implant on (left) contralateral breast of Rt breast recon

    I'm stumped on what cpt code to use since the breast is not the reconstructed breast. it's the contralateral breast (left) that Dr is wanting to basically tighten implant position. We're wanting to get pre determination through insurance and I'm needing a code. Any suggestions? is a 45...
  15. S

    Breast Bx- Dx code

    When billing for a breast bx, is it best to wait for the pathology report to come back to be able to bill with final dx, or can we bill with the reason the bx was done? Thanks
  16. B

    Billing for Implants

    Can the surgeon submit claims for the implants used? If the surgeon supplies the implants and they are not purchased by the ASC, couldn't he submit claims for them? :rolleyes:
  17. C

    Breast reduction on contralateral breast

    We have a patient who was diagnosed with breast cancer in her right breast and Medicare paid for the right breast reconstruction. Medicare denied 19318-LT, the left breast reduction which was needed to make the breasts symmetrical. Diagnoses for left breast are: Macromastia & Breast Asymmetry...