nharrison2
Contributor
Hi, I am trying to teach myself my providers coding. I am certified but have stayed in billing even with my CPC. I haven't taken an active role in my CPC and I want to do that this year. So I took this note which wad billed with 19380 and 19340 but I am finding that 19382 and 19340 is supported is this correct? I don't have any where else to go for these questions so I hope its okay to put them here:
Revision of reconstructed breasts with removal of bilateral breast implants, bilateral capsulectomies, placement of silicone implants and correction of animation deformity. (history of breast cancer)
The patient was brought to the operating room, a time out was performed. General anesthesia was induced and the patient was intubated without difficulty. SCDs were placed for DVT prophylaxis, pre operative antibiotics were given, the patient was secured and properly padded and then prepped and draped in the usual sterile fashion, keeping all important landmarks in visualization.
I then made a inferior mammary incision in the breast on the right side. The entire capsule was dissected from the breast tissue and the implant was removed.
I irrigated the breast with normal saline. There was no silicone or capsule left in the breast. I then allowed betadine to sit in the breast for 5 minutes.
I then made a superior crescent mastopexy incision in the breast on the left side. The entire capsule was dissected from the breast tissue and the implant was removed.
I irrigated the breast with normal saline. There was no silicone or capsule left in the breast.
I then separated the muscle from the breast flap on both sides using minimal cautery. The muscle was then tacked to the chest wall with 0 ethibond sutures.
I then tried multiple sizers with the patient in the sitting position. The durasorb was cut in half and tacked in the inferior pole of the breast to hold the implant on each side.
I then irrigated the pocketed. I then placed interrupted 2-0 Vicryl sutures on the breast.
I used multiple sizers and the patient was set up to evaluate the breast size.
Once I had decided on the appropriate size, on the right breast, I removed the sizer. I checked the breast for bleeding. I irrigated the pocket with Irricept solution, washed the skin with betadine, and irrigated a last time with Irricept solution. I placed new blue towels down and changed my gloves. I then introduced an Irricpet soaked implant into the pocket and tied over the remaining vicryl sutures.
On the left breast, I removed the sizer. I checked the breast for bleeding. I irrigated the pocket with Irrisept solution, washed the skin with Betadine, and irrigated a last time with Irrisept solution. I placed new blue towels down and changed my gloves. I then introduced an Irrisept soaked implant into the pocket and tied over the remaining Vicryl sutures.
The breast was irrigated and then closed in multiple layers using interrupted 2-0 Vicryl, 3-0 Monocryl deep dermal, and a running 3-0 Monocryl.
I placed dressings over the incisions. I placed her in a bra. The patient was extubated and taken to the PACU in stable condition. All instrument, needle and lap counts were correct.
I found that significant revision of a previously reconstructed breast, was not documented. Am I wrong?
Thanks!!
Outside Services on 12/1/2025
D
Revision of reconstructed breasts with removal of bilateral breast implants, bilateral capsulectomies, placement of silicone implants and correction of animation deformity. (history of breast cancer)
The patient was brought to the operating room, a time out was performed. General anesthesia was induced and the patient was intubated without difficulty. SCDs were placed for DVT prophylaxis, pre operative antibiotics were given, the patient was secured and properly padded and then prepped and draped in the usual sterile fashion, keeping all important landmarks in visualization.
I then made a inferior mammary incision in the breast on the right side. The entire capsule was dissected from the breast tissue and the implant was removed.
I irrigated the breast with normal saline. There was no silicone or capsule left in the breast. I then allowed betadine to sit in the breast for 5 minutes.
I then made a superior crescent mastopexy incision in the breast on the left side. The entire capsule was dissected from the breast tissue and the implant was removed.
I irrigated the breast with normal saline. There was no silicone or capsule left in the breast.
I then separated the muscle from the breast flap on both sides using minimal cautery. The muscle was then tacked to the chest wall with 0 ethibond sutures.
I then tried multiple sizers with the patient in the sitting position. The durasorb was cut in half and tacked in the inferior pole of the breast to hold the implant on each side.
I then irrigated the pocketed. I then placed interrupted 2-0 Vicryl sutures on the breast.
I used multiple sizers and the patient was set up to evaluate the breast size.
Once I had decided on the appropriate size, on the right breast, I removed the sizer. I checked the breast for bleeding. I irrigated the pocket with Irricept solution, washed the skin with betadine, and irrigated a last time with Irricept solution. I placed new blue towels down and changed my gloves. I then introduced an Irricpet soaked implant into the pocket and tied over the remaining vicryl sutures.
On the left breast, I removed the sizer. I checked the breast for bleeding. I irrigated the pocket with Irrisept solution, washed the skin with Betadine, and irrigated a last time with Irrisept solution. I placed new blue towels down and changed my gloves. I then introduced an Irrisept soaked implant into the pocket and tied over the remaining Vicryl sutures.
The breast was irrigated and then closed in multiple layers using interrupted 2-0 Vicryl, 3-0 Monocryl deep dermal, and a running 3-0 Monocryl.
I placed dressings over the incisions. I placed her in a bra. The patient was extubated and taken to the PACU in stable condition. All instrument, needle and lap counts were correct.
I found that significant revision of a previously reconstructed breast, was not documented. Am I wrong?
Thanks!!
Outside Services on 12/1/2025
D