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Wiki subQ masctectomies

mad_one80

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orange, ca
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I have a breast specialist that performs nipple-areolar sparing mastectomies. She doesn't want it coded as a "subQ mastectomy" since those procedures are 5x harder and take 2x longer than a simple mastectomy and she refuses to get paid 5x less for doing more intense work. She states that this operation is very difficult and the coding is controversial and I wanted to know what you all think of it? Do you sugguest it be coded using modified radical mastectomy code 19307 or simple mastectomy + SLN code 19303 + 38500/38525?
any sugguests is greatly appreciated!!
 
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