Wiki CPT 19380 and POS of 11

[sfoote7]

Hi!

One of the providers I do billing for coded a Breast Reconstruction Revision done in the office as 19380 with modifier 58. I believe 19380 can only be done in an out patient setting. The provider used this code as out patient 3 months before. If so, what other code can be used for a revision of Breast Reconstruction, in the office?

Thank you!

Silvia Foote

 

[thomas7331]

There's no way to help with code assignment without seeing the provider's documentation. It would be unusual to see this procedure done in an office setting, but if in fact the provider did do this, then that's how it has to be billed. The code choice has to be based on what the provider documented and there isn't an alternate set of codes to use for an office vs. a facility.