Wiki Breast revision and implant replacement

[NPSDEB]

Hello-
My surgeon wants to bill 19380 with 19342. When I ran it thru NCCI edits, it edited out. But in the CPT guidelines, it states to report 19342 separately. Do I bill it with a 59 modifier? For some reason, that just doesn't feel right. Any input?

Thank you for any and all input.
Deb

 

[nickelclaw]

if below per documentation then yes mod on the 19380
CPT code 19380, Revision of reconstructed breast, (eg, significant removal of tissue, re-advancement and/or re-set of flaps in autologous reconstruction or significant capsular revision combined with soft tissue excision in implant-based reconstruction), is assigned when making revisions to a previously reconstructed breast, that require excision of tissue, revision to flaps, revision to the capsule and soft tissue excision, and is not assigned during the second stage of the original reconstruction when the tissue expanders are replaced with breast implants.