• If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten your username or password use our password reminder tool. To start viewing messages, select the forum that you want to visit from the selection below.
  • We're introducing new features and a new look to make the forums easier to use and more valuable to you. See what's new and let us know what you think!

liposuction in gynecomastia mastectomy

TnRushFan

Networker
Messages
46
Best answers
0
Does anyone have an authoritative reference whether to code liposuction (15877) with gynecomastia mastectomy (19300)?
 

TnRushFan

Networker
Messages
46
Best answers
0
liposuction gynecomastia

Both...I would like to know for future knowledge but also have a billable encounter that is going to an insurance company. I'm aware that they will probably deny...but it still needs to be coded correctly.

The provider performed liposuction to remove the 'fatty tissue' then made incisions and removed 'fibrous tissue'. I have found internet chatter that indicates both ways but nothing definitive to code both. One of my coding friends thinks that since fibrous tissue was removed the insurance will pay with proper documentation...
 

CodingKing

True Blue
Messages
3,819
Best answers
0
There are no NCCI edits that I see. Regardless you will need pre-approval for both codes from insurance before performing. Its possible your payer may have a payment/reimbursement policy on possible cosmetic procedures. Also make sure it's not pseudogynecomastia which is obesity related and not true gynecomastia which is caused by a hormonal imbalance. The payer i used to work for does not pay for the obesity related one. There really isn't a one size fits all answer and will likely be up to the payer if they want to reimburse separately
 
Top