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Reconstruction coding

  1. #1
    Daytona Beach, FL
    Question Reconstruction coding
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    I am now coding for a Plastic Surgeon that has joined our surgical group and need some assistance in coding a breast reconstruction.

    The doctor performed 2 reconstructions so far - both were Immediate reconstruction following mastectomy with tissue expander, placement of Alloderm and one was Intermediate closure, the other was complex closure and done bilaterally. How would I code this? I have 19357 for the procedure I believe, but would I also code the Alloderm placement and the closure separately?

    Any guidance would be great!

    Jodi Dibble, CPC

  2. #2
    Default Breast Reconstruction
    You would code 19357-rt, 19357 lt, (depending on insurance carrier and 15330-51 depending on sq cm you may need add on code 15331. You can not bill separetly for the repair it is included in with the 19357. A good book for your office is coding companion for plastic surgery. I find it very useful and will show you what codes are bundled CCI edits.

    Hope this helps,

    Kimberly Hollins, CPC

  3. #3
    Daytona Beach, FL
    Default Many Thanks!!!
    Thank you so much Kimberly for your help! This is what I needed! This Plastic Surgeon and her front desk assistant have been hounding me about this issue, insisting that the closure has to be coded separately and I felt that this would be unbundling, but I need to verify this. Thank you for your response and the coding source - I will definitely get a copy of this book!
    Jodi Dibble, CPC

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