removal and mastopexy


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I am wondering if someone can clarify how I should code this surgery?????

Patient had 1. removal of implants
2. periareolar mastopexy
3. revision of inframammary scar

???? 19316-50
19328-50 ( mutually exclusive NCCI edit w/ 19316)
???? #3 should anything be billed for this procedure

I included the op report :

OPERATIVE TECHNIQUE IN DETAIL: The patient was placed supine on the
operating room table. After induction of general anesthesia the
chest was prepped and draped in a sterile fashion. Bilateral
symmetric 38-mm areolar cookie cutters were used to incise the

The excess areola was then incised circumferentially, and this area
de-epithelialized. The previous placed Gore-Tex sutures were removed
on both the right and left sides. The inframammary crease incisions
were excised in an elliptical fashion, and closed with interrupted
4-0 Vicryl sutures followed by a running subcuticular 4-0 Prolene
suture. The breast incision was then deepened down to the level of
the implant capsule. The capsule was incised, and intact silicone
implants were removed. The pockets were irrigated with saline and
bacitracin solution. A pocket was then closed with 4-0 Vicryl
sutures followed by 4-0 Vicryl sutures in the subcutaneous tissue.
The skin was closed with running subcuticular 4-0 Monocryl suture.
Xeroform, soft dressing and a surgical bra were applied.

The patient tolerated these procedures without any difficulty. She
was discharged to the recovery room in stable condition.