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Coding information

  1. #1
    Question Coding information
    Medical Coding Books
    I am needing help in finding any coding information/guidelines for plastic's ex.. books, coding seminars, web sites etc... I had a physican preform a "small breast reduction" and said that since he only removed 100g of tissue that it is not considered a breast reduction? They also did a mastopexy and according to the medicare cci edits a breast reduction (19318) is mutually exclusive of a mastopexy (19316). I am fairly new at coding these and would like to find more information and guidance for coding these types of procedures. Any help would be greatly appreciated!
    Tonya Vanderpool, CPC
    SMMC Surgicare
    Evansville, IN

  2. #2
    Default info
    Hello,
    Is this all on the same breast? You may get away with billing for both if they are on different breasts.


    Try and get a coders' desk reference book to go along with your cpt book. As for books, you can always check this website for a conference/seminar in your city, sometimes they sell books.

    Good luck!
    Last edited by sundaey; 03-18-2008 at 03:03 PM.
    Malama pono,

    Sundae Yomes
    CPC, CPMA, CEMC, CGIC, CGSC, CCS-P

  3. #3
    Default
    Quote Originally Posted by tlfritts View Post
    I am needing help in finding any coding information/guidelines for plastic's ex.. books, coding seminars, web sites etc... I had a physican preform a "small breast reduction" and said that since he only removed 100g of tissue that it is not considered a breast reduction? They also did a mastopexy and according to the medicare cci edits a breast reduction (19318) is mutually exclusive of a mastopexy (19316). I am fairly new at coding these and would like to find more information and guidance for coding these types of procedures. Any help would be greatly appreciated!

    From what I have seen with my surgeon in reading the operative reports on the mastopexy, he is in fact removing a small amout of breast tissue and does not in any way consider it a reduction. The diagnosis I look for with reductions is 611.1 as the primary and typically around 300 grams is low for reductions unless it is a equalizing reduction for breast cancer patients. Hope that helps.
    Susan Ward, CPC, COC, CPC-I, CEMC, CPCD, CPRC
    AAPC ICD-10 Expert Trainer
    susanwardcpc@live.com

    A small act of kindness a day can make someone's day special

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