19380 second stage reconstruction

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New Hartford, CT
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Dr. is billing 19380 and 11970, would 19370 be more appropriate than 19380?

The patient was taken to the OR where she was placed on the table in the supine position with the arm set perpendicular to table on arm boards.* She was prepped and draped in usual sterile fashion.* Incisions were made through the dermis sharply using a 10 blade along the prior mastectomy incisions.* Electrocautery was used to continue dissection to expose the expanders which were removed and discarded.* Pockets were then irrigated with normal saline.

Extensive capsulotomy, with radial and tangential scoring was performed to allow for implant repositioning and breast shaping.* Inferior adipocutaneous flaps were advanced superiorly and secured with interrupted and running #1 Vicryl suture to create an inframammary crease.* Lateral crease plication was performed similarly to achieve ideal lateral pole shape.* Pockets were then irrigated with normal saline and hemostasis assured with unipolar cautery.* Pockets were then irrigated with antibiotic solution of Ancef bacitracin and gentamicin.

Implants were selected and handled after bathing in antibiotics and placed within the soft tissue envelope.* The pockets were closed in a layered fashion with deep running 2-0 Vicryl suture followed by interrupted deep dermal 3-0 Monocryl and running 3-0 Monocryl subcuticular sutures.* Steri-Strips were placed and sterile gauze and compressive Ace bandage applied.
 
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