AAPC - Back to school
Results 1 to 7 of 7

Thread: Breast recon with latissimus dorsi flap/tissue expnader

  1. #1

    Default Breast recon with latissimus dorsi flap/tissue expnader

    AAPC: Back to School
    Would anyone have a suggestion regarding this scenario?

    Breast recon with Latissimus Dorsi flap and a tissue expander placement at the same session, same side.


  2. #2
    Join Date
    Apr 2007
    Charleston, WV


    19361 & 19357-51 ?

  3. #3


    I persoally would bill for 19361 and 19340. I would not do 2 reconstrucation codes for the same breast.

  4. #4


    19357 includes expansions for 90 days. If you bill with 19340 you are not paid for the subsequent expansions. I use 19361 and 19357.

  5. #5
    Join Date
    Apr 2007

    Default 19357 and 19361

    I would bill cpt code 19361 with a 59 modifier and cpt code 19357 with 52 modifier...

    If a latissimus dorsi breast reconstruction requires the insertion of a tissue expander, the intraoperative work is not sigificantly different from that of implant insertion. The post-operative time and work, however, are greater because the patient must be seen many more times postoperatively for tissue expansion. It is appropriate to code separately for tissue expander placement, but one should use modifier -52 and append -59 modifier to the 19361 - CPT Corner...


  6. #6


    19361 and 19357-59. CPT Corner June 2009

  7. Smile latissimus dorsi myocutaneous flap with expander

    I would not use 19357 but would instead use 19361 and 19340 referenceing the CPT assistant ,March 2010 page: 9, 10 . Question:

    What are the appropriate codes to report for a breast reconstruction with latissimus dorsi flap and with tissue expander?


    For breast reconstruction with latissimus dorsi flap and with tissue expander, the correct codes are 19361 and 19340 (as the tissue expander is considered to be a breast prosthesis). It would not be appropriate to separately report code 19357, Breast reconstruction, immediate or delayed, with tissue expander, including subsequent expansion.

    Previously, code 19361's descriptor included "with or without" that some read as indicating the inclusion of the insertion of an implant (when performed), rather than that the service may be done in conjunction with the use of an implant. For CPT 2007, the "with or without" was removed from the descriptor to clarify separate reporting of the additional effort to prepare and insert a prosthetic implant beneath a muscle flap for breast reconstruction. In addition, a parenthetical instruction was added following code 19361, to direct users to report code 19340 for insertion of the prosthesis, when performed in conjunction with breast reconstruction with latissimus dorsi flap, without prosthetic implant (code 19361).

    I hope this clarifies the confusion on which codes to use

Similar Threads

  1. Replies: 0
    Last Post: 12-26-2014, 09:14 AM
  2. Latissimus dorsi flap and tissue expander
    By TMHales in forum Plastic Surgery
    Replies: 7
    Last Post: 05-06-2014, 07:56 AM
  3. Dorsi Flap
    By codedog in forum Plastic Surgery
    Replies: 0
    Last Post: 07-16-2009, 01:52 PM
  4. latissimus dorsi muscle tear
    By cresmondowilliams in forum Medical Coding General Discussion
    Replies: 0
    Last Post: 03-18-2009, 08:53 AM
  5. Latissimus Dorsi Flap
    By bourdeau in forum Plastic Surgery
    Replies: 1
    Last Post: 10-29-2008, 01:52 AM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts

Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.