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Thread: Nipple reconstruction with tattoo

  1. #1
    Join Date
    Apr 2007

    Question Nipple reconstruction with tattoo

    AAPC: Back to School
    Our plastic surgeon is looking into performing nipple tattooing after reconstruction. Does anyone know if this would be included in the original nipple reconstruction or if it would be separately billable? I see that NCCI edits bundle 19350 & 11920 with modifier allowed. However, procedures would be performed in separate sessions. I cannot find anything definitive regarding this but I have come across many "colorful" tattoo sites researching this! Btw, these would be post-mastectomy reconstructions.

    Shannon, CPC, CCA

  2. #2


    According to the ASPS tattooing is included in nipple recon.

  3. #3
    Join Date
    Apr 2007
    Oak Ridge


    Yes, you can bill tattooing - just not during the post-op time frame. The use of 11920 {11921} would be used out of the postoperative global period. Tattooing is included in 19350 as well as in 19357-19369 when performed at the time of the breast reconstruction procedure or in the office during the postoperative global period. For area's greater than 6.0 sq cm or bilateral (do not use modifier 50) report with 11921.

    I hope this information is helpful!

    Sunshine Whitus, CPC, CPMA

  4. #4


    Hi Sunshine,
    Do you have this in writing by an "official source"? My surgeons don't believe me when I tell them this. If I had something official to back myself up, it would be very helpful.

    Thank you,


  5. #5
    Join Date
    Apr 2007
    Adirondack Chapter of Professional Coders, Glens Falls, NY


    I was always under the impression that 11920 was reimburseable separately at a different session from the reconstruction. I don't have anything it writing, but our patients typically come in for the tattooing when they are outside of the global from the reconstruction and we have never been denied payment for it....

  6. #6


    Outside of the global period, I don't have issues. It's within the global period of the reconstruction is where I'm having the conflict.


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