Bilateral breast reconstruction w/tissue expander and bilateral serratus muscle flap

dchagy

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Need your expertise re: ASC procedure

1.Bilateral breast reconstruction with tissue expander
2.Bilateral serratus muscle flap.

In order to obtain good lateral cover over the implants, the skin cover was relatively thin. The outer portion of the serratus muscle was elevated along with its fascia and this was dissected back for about 7cm sufficient ot accommodate the later footprint of the implant. Patient is status post bilateral mastectomy for treatment of right breast cancer. She has had chemo and now ready for reconstruction process.

Should 19357-50, 15734, 15734-59, and L8699 x 2 (Allegan style 133 MX) be coded for this procedure? Or
Should a 19366-50 and 19340-50 or 19357-50 and 14001?
I think I have over analyzed this! Get me back on track!!

Would like any coding resources on the serratus muscle flap. Thank you in advance.
 
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