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Dr. Herb Goldberg
Dr. Herb Goldberg, Board Certified Plastic Surgeon
Category: Plastic Surgery
Satisfied Customers: 293
Experience:  35 years experience in cosmetic and reconstructive plastic surgery. Certified by the American Board
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I have a CPT coding question. How do I code the following

Customer Question

I have a CPT coding question. How do I code the following surgery: Second stage left breast reconstruction with removal of expander, capsulopexy, placement of implant; right reconstructive mastopexy with capsulopexy and implant exchange. I am so confused about what is bundled with what in the breast surgery reconstruction codes. Any help would be greatly appreciated!
Submitted: 3 years ago.
Category: Plastic Surgery
Expert:  Dr. Herb Goldberg replied 3 years ago.

Dr. Herb Goldberg :

Thanks for your question. Plastic surgeons often use outside coders to help them with billing and coding. 119705 probably would be used in reconstruction of the left side along and would cover the placement of the implant. Removal of the expander or the previous implant on the right would not be covered by insurance usually. Bilateral capsulopexy would be 19370-50 for bilateral. The right side should be covered for symetry and would be 19325 and 19316 for the implant and the mastopexy. I hope this helps.

Customer:

Thanks so much for your help. I was coding it the following way: 19357, 19370-50, 19316-50, 19340-50 and 19328, but I thought some of the codes might be subsumed under the initial surgery. I really appreciate your help.

Dr. Herb Goldberg, Board Certified Plastic Surgeon
Category: Plastic Surgery
Satisfied Customers: 293
Experience: 35 years experience in cosmetic and reconstructive plastic surgery. Certified by the American Board
Dr. Herb Goldberg and other Plastic Surgery Specialists are ready to help you
Customer: replied 2 years ago.

I have another similar case which I am coding and wondered how you would code the following: Second stage of right breast reconstruction with removal of expander and placement of implant; left reconstructive augmentation, and mastopexy?

 

Once again, thank you so much for your help.

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    Board Certified Plastic Surgeon

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    35 years experience in cosmetic and reconstructive plastic surgery. Certified by the American Board
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Dr. Herb Goldberg
Dr. Herb Goldberg
Plastic Surgeon, retired
292 Satisfied Customers
35 years experience in cosmetic and reconstructive plastic surgery. Certified by the American Board