liposuction in gynecomastia mastectomy

TnRushFan

Networker
Messages
52
Location
Smyrna, TN
Best answers
0
Does anyone have an authoritative reference whether to code liposuction (15877) with gynecomastia mastectomy (19300)?
 

TnRushFan

Networker
Messages
52
Location
Smyrna, TN
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
3,921
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