nsteinhauser
Expert
Surgeon removes ruptured breast implant materials, entire capsules are excised and new implants are placed. Patient has distant history of bilateral mastectomies with reconstruction.
One resource states 19371 and 19340. The 19371 includes removal of old implant. It doesn't include removal of ruptured implant material that takes more time and work. I can't modify the 19371 with a -22 (increased services) because I am coding for a facility and -22 is not allowed in ASC's. Using 19330 would include removal of ruptured implant material but doesn't include a capsulectomy. Also there is a question that the 19340 "..or in reconstruction" is only to be used for immediate reconstruction, not reconstruction years later.
19380 would fit for reconstruction of a breast that has already been reconstructed, albeit not for asymmetry. 19371 could be coded additionally to indicate capsulectomy. But again I'm wondering how to code for the fact it was removal of ruptured implant material and not just an intact implant.
Thank you in advance for any thoughts out there.
One resource states 19371 and 19340. The 19371 includes removal of old implant. It doesn't include removal of ruptured implant material that takes more time and work. I can't modify the 19371 with a -22 (increased services) because I am coding for a facility and -22 is not allowed in ASC's. Using 19330 would include removal of ruptured implant material but doesn't include a capsulectomy. Also there is a question that the 19340 "..or in reconstruction" is only to be used for immediate reconstruction, not reconstruction years later.
19380 would fit for reconstruction of a breast that has already been reconstructed, albeit not for asymmetry. 19371 could be coded additionally to indicate capsulectomy. But again I'm wondering how to code for the fact it was removal of ruptured implant material and not just an intact implant.
Thank you in advance for any thoughts out there.