Results 1 to 3 of 3

Breast removal/replace implant

  1. #1
    Default Breast removal/replace implant
    Medical Coding Books
    I have a situation that dr. did a remove/replace implants on a patient as cosmetic procedure ( implants harden) Now over a month later- wound opened with infection. Previously no signs of problems and pt was getting along fine.
    Can dr remove the implant under insurance? Pt has medicare & 2nd coverage. He will be doing this in the office.

  2. Default
    Since the patient has Medicare, you should review your Local Coverage Determination (LCD). Our carrier is WPS and they will cover removal of the implant with diagnosis 996.54 for example. Please note that while the removal of the implant may be covered regardless of whether the implant was placed for reconstructive or cosmetic purposes. They probably won't cover placing a new implant if it is being performed for cosmetic purposes.

  3. #3

Similar Threads

  1. Breast Implant Removal during Mastectomy
    By AimeeNK31 in forum General Surgery
    Replies: 0
    Last Post: 05-29-2014, 09:36 AM
  2. Breast Implant Removal due to Cardiac Surgery
    By become359 in forum Plastic Surgery
    Replies: 2
    Last Post: 03-18-2014, 09:24 AM
  3. Removal of breast implant?
    By BFAITHFUL in forum Plastic Surgery
    Replies: 0
    Last Post: 04-10-2012, 11:17 AM
  4. Removal of tissue expander, breast implant, & revision
    By Kevinph84 in forum Plastic Surgery
    Replies: 2
    Last Post: 10-18-2011, 01:06 PM
  5. Replace breast expander with implant
    By lomasona in forum General Surgery
    Replies: 0
    Last Post: 04-14-2009, 11:01 AM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.