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19350 with 15130? Nipple Reconstruction

  1. Red face 19350 with 15130? Nipple Reconstruction
    Medical Coding Books
    Hi everyone. I'm trying to figure out if I can code separately for dermal grafts used during a nipple reconstruction. I am using 19350. And in the description in cpt, it says the physician excises graft skin, etc., but it makes no mention if the graft can be coded separately. I checked the CPT Assistant references in the skin grafts and other integmentary codes and in the breast codes (lots of info) but it never addresses this specific question that I can find. I would use 15130 if it was ok to code separately.

    If anyone out there knows the answer, I'd sure appreciate it. Thanks!

  2. #2
    Default
    We do not report the skin graft in our office, just the nipple reconstruction code.

  3. Default
    I used to bill full thickness and split thickness skin grafts separate with 19350.I never billed for dermal but I think it would be billable sep.

  4. #4
    Default Tinaboe
    Hello,

    There is an article in the CPT Corner put out by the American Society of Plastic Surgeons which states...

    19350 is the global code for nipple-areolar reconstruction. It includes the formation of the nipple mound by any of the various flap methods, as well as the creation of the areola with a skin graft.
    To code separately for the flap (14000) and the graft (15200) is unbundling, as 19350 includes both the flap and the graft. If anything less than a flap and graft is done, then the "reduced services" modifier, "-52," should be used to indicate that only a portion of the procedure was
    performed.

    So with this being said - I do not code separately for the grafts.

  5. #5
    Location
    North Carolina
    Posts
    3,126
    Default
    Quote Originally Posted by tinaboe View Post
    Hello,

    There is an article in the CPT Corner put out by the American Society of Plastic Surgeons which states...

    19350 is the global code for nipple-areolar reconstruction. It includes the formation of the nipple mound by any of the various flap methods, as well as the creation of the areola with a skin graft.
    To code separately for the flap (14000) and the graft (15200) is unbundling, as 19350 includes both the flap and the graft. If anything less than a flap and graft is done, then the "reduced services" modifier, "-52," should be used to indicate that only a portion of the procedure was
    performed.

    So with this being said - I do not code separately for the grafts.
    Does anyone, by chance, have a copy of this article?

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