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Thread: Help!! Surgeon billing nippled reconstruction

  1. #1

    Default Help!! Surgeon billing nippled reconstruction

    AAPC: Back to School
    I need help with this operative report surgeon gave be 19120 and 19350-52. I do not see evidence of the nipple reconstruction. Please help me!!

    At this point, using the scalpel only, a columnar wedge shaped portion of the nipple was excised, centered at the 6:00 position, and including the palpable 6 mm nodule. This incision was carred down into the tissues immediately deep to the nipple skin. The incision was then carried inferiorly across the entire portion of the areola as tw separate incisions extending from the base of the nipple to the inferior border of the nipple areolar complex skin. The excised skin of the areola was then mobilized and the entire specimen including a portion of the nipple iteself was then excised. Bleeding was controlled using minimal amounts of electrocautery. At this point, using 5-0 Vicryl sutures, nipple parenchymal tissue was reapproximated deep to the nipple skin. The nipple skin itself was reapproximated using interrupted sutures of 6-0 nylon. The inferior flaps of the areolar skin were then mobilized from the subcutaneous fat. This allowed the corners of the areolar skin to be approximated at the edge of the nipple reolar complex skin. Subcutaneous subareolar tissues were then approximated with interrpted 4-0 Vicryl.The skin of the areola as well as the skin at the edge of the nipple areolar complex was then reapproximated using two subcuticular sutures of 4-0 Monocryl and Steri-Strips. Dry steril dressing was applied, and the patient having tolerated the procedure well, was awakend and takent to the Surgical Short Stay Unit in god condition.

  2. #2
    Join Date
    Apr 2007


    There is a CCI edit with 19120 & 19350. That means it has to meet the modifier 59 standards to be able to bill together. So best advice, make your judgement on utilizing the 59.

  3. #3


    So, to you this note looks to include the nipple reconstruction?

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