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Nipple reconstruction-help

  1. #1
    Default Nipple reconstruction-help
    Medical Coding Books
    A very long elliptical incision was then made in the lateral aspect of the breast in the axilla. Excess skin as well as adipose tissue was removed down to the level of the latissimus muscle. This was then carried out further medially on the anterior aspect of the breast to allow for a normal contour. This left a very widely gaping wound, approximately 7 cm in the greatest diameter. Extensive soft tissue undermining was required to close this. Incision was then closed in layers using 2-0 Vicryl to reapproximate the fascia in the dermis followed by another layer of 3-0 Vicryl to reapproximate the dermis and the skin was closed in running subcuticular fashion with 4-0 Monocryl suture.

    Next, the nipple position had been marked preoperatively in standing position. A CV flap was then formed using a 1-cm diameter nipple. Three flaps were incised and elevated and the medial and lateral flap was used for support. The dermis was secured with 3-0 Vicryl sutures and the flap was formed using 4-0 Monocryl sutures.



  2. #2
    I use 19350 for nipple reconstruction. Our reconstruction usually involves a full thickness skin graft to help with the reconstruction which is 15200 (trunk). If it's bilateral use the 50 modifier or RT / LT and a 59 for the graft.

    Maybe this might help?

  3. Default
    According to the ASPS CPT 19350 "includes creation of the nipple with a local tissue flap and/or skin graft adn/or any tattooing within the global period (do not use 1400X, 1510X or 1520X in addition to 19350)." This was presented at the conference in August 2011 in Chicago.

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