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Wiki Reconstruction coding

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jdibble

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I am now coding for a Plastic Surgeon that has joined our surgical group and need some assistance in coding a breast reconstruction.

The doctor performed 2 reconstructions so far - both were Immediate reconstruction following mastectomy with tissue expander, placement of Alloderm and one was Intermediate closure, the other was complex closure and done bilaterally. How would I code this? I have 19357 for the procedure I believe, but would I also code the Alloderm placement and the closure separately?

Any guidance would be great! :)

Thanks,
 
Breast Reconstruction

You would code 19357-rt, 19357 lt, (depending on insurance carrier and 15330-51 depending on sq cm you may need add on code 15331. You can not bill separetly for the repair it is included in with the 19357. A good book for your office is coding companion for plastic surgery. I find it very useful and will show you what codes are bundled CCI edits.

Hope this helps,

Kimberly Hollins, CPC
 
Many Thanks!!!

Thank you so much Kimberly for your help! This is what I needed! This Plastic Surgeon and her front desk assistant have been hounding me about this issue, insisting that the closure has to be coded separately and I felt that this would be unbundling, but I need to verify this. Thank you for your response and the coding source - I will definitely get a copy of this book!
 
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