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Thread: Breast Tissue Expander

  1. #1
    Join Date
    Apr 2007
    Milwaukee WI

    Default Breast Tissue Expander

    AAPC: Back to School
    Okay ... this is for a pre-authorization for surgery. So I don't have an op report yet. Here is what the surgeon's assistant sent me ...
    This patient has a tissue expander in her right breast for burns she sustained as a child (she is now 18). The expander has folded onto itself and doctor wants to inject it but in the OR under sedation as she cannot tolerate the large needle needed, plus the expander isn't in a normal position. Any idea what code I can use for this????

    On further investigation ... the OR is booked for only 30 minutes. Surgeon is certain that he will only need to fill the expander. He does not believe he'll be replacing it, as it was placed so long ago as to be completely encapsulated by now. The expander has not ruptured, and he feels he can inject it with good result.

    Right now I'm thinking 19499 Unlisted Procedure, Breast. But I'd welcome anyone else's suggestions.

    Oh, and I promise to let you know what eventually happens!

    Thank you in advance for your help.

    F Tessa Bartels, CPC, CEMC

  2. #2

    Default Filler

    How far is the needle going? If subq ... what about 11950-11954, the code varies based on CC's.

    Just a suggestion. Otherwise, I'd stick to the unlisted.

  3. #3
    Join Date
    Apr 2007
    Milwaukee WI

    Default 19499

    Well, we went with the unlisted code ... 19499.

    We did get pre-auth from the patient's insurance (AFDC HMO) for this unlisted code.

    I'll let you know if we get paid.

    F Tessa Bartels, CPC, CEMC

  4. #4
    Join Date
    Apr 2007
    Milwaukee WI

    Default We got paid

    We got paid by AFDC for this procedure. (Yippee Skippee)

    F Tessa Bartels, CPC, CEMC

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