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Help with Breast Reconstruction Revision

  1. #1
    New Port Richey & Gulf to Bay
    Question Help with Breast Reconstruction Revision
    Medical Coding Books
    Hello Everyone,

    I work for the ASC setting. I was wondering if someone could direct me to the correct CPT for this case.

    The provider admitted a patient for revision of bilateral breast reconstruction for a patient that developed bilateral breast wounds, status post history of breast cancer. However, when reading the operative report, it seems for one breast, he is not performing a true breast reconstruction.

    "At this time, attention was directed to the right breast. The eschar which had been seperated was dissected free from its base and removed in toto and was sent for permanent pathology. At this time, there was noted to be good granulation tissue at the base. There was no wound opening with no exposed implant. The area was widely irrigated with bacitracin irrigation. Hemostasis was assured using electrocautery. After which, attention was turned towards the left breast reconstruction."

    Do you report this with 19120 or perhaps a code from the benign skin lesions (i.e. 11400-) or would you still consider this a revision of breast reconstruction, regardless that the provider did no tissue rearrangement?

    Thank you all for your help.

  2. #2
    looks like a debridement. Check out 11042 ect.

  3. #3
    I agree it sounds a debridement of a wound. Make sure if you use a debridment code make sure you use appropriate modifier if still in post op.

  4. #4
    Quote Originally Posted by kdhecb1 View Post
    I agree it sounds a debridement of a wound. Make sure if you use a debridment code make sure you use appropriate modifier if still in post op.
    The patient would not be within the global for a different rendering physician especially belonging to a different entity. So there for, will not need a 78 unless service provided by original surgeon and or within the same specialty organization...

  5. Default
    I don't think a modifier is needed in an ASC setting unless it's a return back to the OR on the same date of service - we have a 24 hour global.

  6. Default
    I too agree with debridement of wound-11042...

    Nalini CPC

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