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Tissue Expander Question

  1. Smile
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    Thanks Karen , that's exactly what I needed

  2. Default Tissue Expander Question
    Hello Karen,

    I saw your response to this previous post so I wanted to get your feedback...but here is the situation...it's a little different.

    The patient had previously undergone bilateral mastectomy and immediate bilateral tissue expander AlloDerm reconstruction. Patient developed complications (within the global period) from the left tissue expander (left breast drain infection) and was readmitted, where the left chest tissue expander was removed and replaced.

    This situation is different in that the permanent prosthesis has not yet been inserted.

    The original breast reconstruction code of 19357 was used, and now we need to code the procedure to remove and replace the left chest tissue expander without prosthesis. The following codes are not appropriate: 11960 (other than breast), 11970 (with prosthesis), 19330 (tissue expander is not implant material), and 19380 (not a revision of a reconstructed breast).

    Do you think the phrase 'including subsequent expansion' in 19357 would refer to any time a tissue expander is removed and/or replaced, regardless of the reason, i.e., infection, leakage, defective, more expansion is needed, etc., and therefore would be nothing further to code? There is code 11971, but that is just for the removal of the tissue expander...does not code for the replacement.

    Please advise; your help is much appreciated!

  3. #13
    Location
    Albany, New York
    Posts
    456
    Default
    Hello......

    Your choice is 19357 (because code descriptor says "Breast Reconstruction,immediate or delayed, with tissue expander")

    I would not code the removal of the original expander separately....you have to take the old one out to put the new one in.

    Hope this helps..........
    Karen Maloney, CPC
    Data Quality Specialist

  4. Default Tissue Expander Question
    Thanks for the quick response, Karen!

    So just to confirm...the original reconstruction was billed with code 19357 and the subsequent procedure to remove and replace the tissue expander due to infection would also be billed with code 19357 with modifier 78 (unplanned return to OR during the global period, etc.), right?

  5. #15
    Location
    Albany, New York
    Posts
    456
    Default
    I think you may want to use Modiifer "76" or "77" instead........
    Karen Maloney, CPC
    Data Quality Specialist

  6. Default
    What are the codes for INSERTION of tissue expander?

    Is there a HCPCS code?

  7. Question
    Is there a cpt code for filling a tissue expander that was placed by a different surgeon?

  8. #18
    Location
    Milwaukee WI
    Posts
    4,466
    Default Are you taking over post op care?
    Quote Originally Posted by msgoodwin View Post
    Is there a cpt code for filling a tissue expander that was placed by a different surgeon?
    Assuming the different surgeon is NOT in your same practice ...

    Are you taking over post-op care? If so, you should be coding the procedure with a -55 modifier (and the surgeon who placed the expander should use a -54 modifier).

    Hope that helps.

    F Tessa Bartels, CPC, CEMC

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