Results 1 to 3 of 3

Removal of tissue expander, breast implant, & revision

  1. #1
    New Port Richey & Gulf to Bay
    Question Removal of tissue expander, breast implant, & revision
    Medical Coding Books
    My Fellow Coders,

    I have a patient who under went breast surgery involving the removal of a tissue expander with a permanent prosthesis, and revision of the SAME breast due to asymmetry. The technique used liposuction to reduce the breast to match the native. I'm a little conflicted here.

    11970 would be applied for the removing of the tissue expander and insertion of a permanent prosthesis.

    19380 would be used for the revision of the breast reconstruction. 19380 is typically used for correcting asymmetry. According to the lay description I have available, exchange of a prosthesis is included (not a tissue expander). Does the correction also include the lipsuctioning? If it doesn't, do you report a traditional liposuction CPT code?

    I had read somehwhere that 11970 would be reported by itself, because all the work to make the breast symmetrical would be included. Then going by the lay description, it seems 19380 could be the sole procedure. Then again, does that include the liposuctioning? 11970 and 19380 do not hit an NCCI edit, but despite that I feel one or the other are potentially included. Any literature corresponding on how to handle this case would be greatly appreciated. Thank you all for you assistance.

  2. Default
    I have a similar case and am pondering how to bill....

  3. Default
    Apparently there is alot of discrepancy on how to bill these. In our facility we bill both since they are not bundled by CCI edits. Most carriers (except Anthem) are paying both. We typically do not bill for the liposuction but if you want to look at it check out code 15877.

Similar Threads

  1. breast tissue expander/implant exchange
    By tabithal in forum Plastic Surgery
    Replies: 1
    Last Post: 04-03-2015, 03:23 PM
  2. Implant removal & scar revision
    By Clmarasco in forum Orthopaedics
    Replies: 0
    Last Post: 02-11-2015, 09:55 AM
  3. Removal & Replacement tissue expander
    By Joyce Burchett in forum Plastic Surgery
    Replies: 0
    Last Post: 04-18-2014, 03:40 PM
  4. Revision of reconstructed breast with tissue expander
    By shante in forum Plastic Surgery
    Replies: 1
    Last Post: 06-21-2010, 12:33 PM
  5. Replace breast expander with implant
    By lomasona in forum General Surgery
    Replies: 0
    Last Post: 04-14-2009, 11:01 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.