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Capsulotomy question

  1. #1
    Arrow Capsulotomy question
    Medical Coding Books
    We have a patient who needs to have a capsulotomy, the breast implants removed & smaller implants put in. She has had several previous procedures (none of them by us) which include: masectomy of the left & insertion of expander; later had her right breast removed & implants put in on both sides; (she has undergone chemo & radiation); and, she has had several revisions with smaller implants put in.

    Now, she has capsular contracture, with her right breast is too high, and scar dents across both where mastectomy scars are. Right implant is 2 cm higher than the left. Scars are sticking to the chest wall of both inferior lateral breasts.

    Will you please help me determine the cpts for pre-auth? I can't decide between:

    19328-50 with 19340-50 or, 19328-50 with 19325-50

    Thanks in advance!
    Last edited by CynthiaT; 07-14-2009 at 12:52 PM.

  2. Default
    The capsulotomy includes removal of the implant, since you are placing implants for reconstruction I would use 19370-50 and 19340-50.

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