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CODING & BILLING
you may report 19330 along with 19371, per the November 2001 CPT
Assistant. (Note: Some payers allow coding of 19371 along with 11970).
• When capsulotomy is used as the approach for the implant, don't
separately report code 19370 [Open periprosthetic capsulotomy, breast].
This code is intended to report adjustments made to the breast capsule.
• The implant removal code (19328) is not separately reportable
with implant replacement (19340), according to the "CPT Corner" article in the March 2013 Plastic Surgery News.
• The excision of a small part of the capsule for minor adjustment is
considered included in the replacement procedure, according to the
April/May 2013 Plastic Surgery News.
Code 19380 [Revision of reconstructed breast] is a non-specific code
intended to capture revisional procedures other than capsulotomies
and capsulectomies. As the code descriptor states, in order to report
19380, the procedures must be performed on a breast that has already
been reconstructed. According to the March 2013 Plastic Surgery
News, this code may include the following procedures:
• liposuction for asymmetry;
• excision of excess tissue (excision and repair of dog ear is coded
to the appropriate benign skin lesion excision and repair codes);
• rearrangement of tissue for asymmetry;
• adjustments to the inframammary crease; and
• repositioning of a previously placed flap (report the original flap
code with a -52 modifier when the entire flap or most of the flap must
be re-elevated).
For reconstruction of the nipples, which is not included in implant
placement, report code 19350 [Nipple/areola reconstruction]. Any
flaps/tissue rearrangement, grafts, tattooing or other procedure inher3 8
O U T PAT I E N T S U R G E R Y M A G A Z I N E O N L I N E | S E P T E M B E R 2013