Wiki Fat Grafting

We use 19380 for fat grafting in breast recon. From an article in the Plastic Surgery News May 2009. 20926 is appropriate if a small, post-breast reconstruction soft itissue defect is grafted with fat. If a large area or mutiple areas of a reconstructed breast are injected, this is better described as a "revision" of a breast reconstruction, and code 19380 is more appropriate.
 
We use 19380 also when it comes to breast reconstruction fat grafting. We use 20926 when it's a different area (like a port scar for example).

However, recently I've read that the ASPS has published an article specifically stating that 19380 should ONLY be used if the reconstruction is completed. Sometimes our surgeons will do fat grafting in between reconstruction stages so if we follow the new ASPS ruling I am at a loss at to what code to use then as well. 20926 doesn't seem to be a high enough code for 200 cc of fat grafting to the breast.

Has anybody else read this article?

Thanks, Nichole
 
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