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Thread: don't think it's 19380?

  1. #1

    Default don't think it's 19380?

    AAPC: Back to School
    Our doc. wants to bill the following CPT 19380, but isn't this just more of a excision of scar of the skin??

    DX: Status post right breast reconstruction for right breast cancer, contracture and deformity of breast reconstruction

    Operation: Excision of hypertrophic scar and release of contracture on te right reconstructed breast with complex plastic surgical closure


    The patient had right breast cancer and underwent flap reconstruction many years ago. At this point, the patient was noted to have a hypertrophic scar on the lateral aspect of the reconstruction with contractures and deformity. The operation was carried out under MAC anesthesia. Local anesthesia was injected into the area of the surgery. The hypertrophc scar was removed by sharp dissection. All contractures were released by sharp dissection. Hemostasis was achieved with cautery where necessary. The edges of the wounds were then undermined where necessary. The wound was closed in layers using 4-0 and 5-0 Monocryl sutures as well as 5-0 Prolene stitches . Steri-Strips and Opsite were applied to the wound.

  2. #2
    Join Date
    Apr 2007
    Milwaukee WI

    Default I agree

    I agree with you. I do not think this is 19380 either.

    F Tessa Bartels, CPC, CEMC

  3. #3

    Exclamation ???? 19380

    Review 15002, Surgical Prepartion. You should use a RT or LT modifier and use a closure code and it has to be Intermediate or Complex code. I have had carriers to deny the closeure as part of the procedure some times. So I appeal with the 59 and notes and it is a toss up if the closeure gets paid.

    Good Luck
    Last edited by vlwinfrey; 05-24-2010 at 09:08 AM.

  4. #4


    thank you both!!!!

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