icd-9 dx code for breast expander fill

What is the CPT code for breast tissue expander?

CPT 19357CPT 19357 is used for tissue expander placement in breast reconstruction; includes subsequent expansion(s); and is separately re- portable if used in flap reconstruction.

Is a tissue expander an implant?

A tissue expander is an empty breast implant. Your surgeon will place it during your mastectomy. The usual hospital stay after a mastectomy with breast reconstruction is less than 24 hours. That means you may go home the same day as your surgery.

What is the correct coding for the removal of breast tissue expander and replacement with a breast implant?

CPT code 11970 should be used for removal of tissue expander and replacement with a breast implant. Code 19357 is separately reportable if used in flap reconstruction, such as a lat dorsi flap (19361).

What is the CPT code for removal of left breast tissue expander with light pocket debridement and irrigation?

The CPT code for removing a tissue expander in the office is the same as it is if the TE was removed in the hospital – the physician reports 11971 (Removal of tissue expander(s) without insertion of prosthesis).

How are breast tissue expanders filled?

The expander is filled by inserting a needle into the self-sealing valve, which may be under the skin, or by using a remote dosage controller to fill the expander with carbon dioxide.

What is a breast expander?

These are implantable, expandable, balloon-like devices used to stretch breast skin and chest wall muscles over several months. Expanders are used so that breast implants can be adequately accommodated. 1. A tissue expander can be placed during a mastectomy or later on after you've healed.

How do you code breast reconstruction?

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.

What is the primary code for CPT 15777?

Code +15777 applies specifically for placement of a biologic implant (such as acellular dermal matrix) for soft tissue reinforcement or to correct a soft tissue defect (for instance, in the breast or trunk) caused by trauma or surgery.

Can 11970 and 19370 be billed together?

The updated guidelines for 2021 instruct providers to use CPT code 11970 together with CPT code 19370 (Revision of peri-implant capsule, breast, including capsulotomy, capsulorrhaphy, and/or partial capsulectomy) in that scenario.

What is the difference between CPT code 19370 and 19371?

A CPT Assistant newsletter states “A capsulectomy (CPT code 19371) involves removal of the capsule. The implant is also removed and may or may not be replaced.” Therefore, CPT 19370 (capsulotomy) is included in 19328 when performed to remove the implant.

What is procedure code 19325?

CPT® Code 19325 in section: Repair and/or Reconstruction Procedures on the Breast.

What does CPT code 19340 include?

CPT® 19340, Under Repair and/or Reconstruction Procedures on the Breast. The Current Procedural Terminology (CPT®) code 19340 as maintained by American Medical Association, is a medical procedural code under the range - Repair and/or Reconstruction Procedures on the Breast.

Are tissue expanders bigger than implants?

Mine are definitely a bit smaller. My plastic surgeon explained that the expander is much harder (like a water ballon, but the implant have a more natural, softer feel. So it is more spread out.

How long does it take for tissue expanders to implant?

Approximately one to three months after the tissue expander has reached the correct size, you will undergo a second operation. During this surgery, the expander is removed and an implant is inserted in its place. The surgery lasts about one to two hours and is followed by a hospital stay of four to 24 hours.

How long can tissue expanders be left in?

But keeping the fluid filled expander means that you don't need to have a second operation. If you are having the expander left in, your surgeon inflates it until it is slightly larger than your natural size. They leave it for 2 to 3 months.

How long is recovery from tissue expanders to implants?

Recovery Time You'll probably be able to return to your usual activities in about 4-6 weeks. If you have a tissue expander removed and replaced with a permanent implant, recovery will take about 2 weeks.

What modifier should be added to the code for a breast surgery?

Hospital coders should be sure to add modifier “LT” to the code to show the procedure was performed on the left breast.

What is the ICD-9 code for infection due to the presence of an implant?

For the ICD-9 code assignment, coders should check in the index under “infection due to the presence of an implant, postoperative wound” and will arrive at code 996.69. Assignment of code E879.8 indicates this was a late reaction/complication that occurred.

What is CPT code 10180?

CPT code 10180 describes the incision and drainage of the postoperative wound. In the documentation, the physician stated, “Copious purulence was suctioned from the wound,” which reflects the incision with drainage. He further documents the tissue expander was removed from this wound without the insertion of a permanent prosthesis. Therefore, the first stop in the index will be to find the entry for the removal of the tissue expander. So, you will look up the word Removal in the index. Among the many choices under this term, you will find Tissue Expanders and the indented term of Skin . 11971. A review of this in the integumentary subsection of the surgical section of the CPT manual shows this is correct.

What is 996.69?

996.69 Infection and inflammatory reaction due to other internal prosthetic device/implant/graft

What is the CPT code for cosmetic surgery?

Please use diagnosis code: Z41.1 Encounter for cosmetic surgery.

Do you need to bill with G0429?

Both diagnosis are required on the claim. Must be billed with G0429.

Is cosmetic surgery covered by Medicare?

Cosmetic procedures and/or surgery are statutorily excluded by Medicare. Please refer to:

Can you use CPT in Medicare?

You, your employees and agents are authorized to use CPT only as contained in the following authorized materials of CMS internally within your organization within the United States for the sole use by yourself, employees and agents. Use is limited to use in Medicare, Medicaid or other programs administered by the Centers for Medicare and Medicaid Services (CMS). You agree to take all necessary steps to insure that your employees and agents abide by the terms of this agreement.

What is the code for a bilateral tissue expander?

For example, the patient has bilateral tissue expanders with dermal matrix placed on May 1. This surgery is coded 19357-50 and 15777-50. The patient presents for her first fill on June 1, and has subsequent fills on June 17, June 30, and July 19. On Aug. 5 the patient returns again. This service is outside of the 90 day global period for the tissue expander insertion. During her visit for the fill, the physician completes a problem focused history and exam with straightforward medical decision-making. This visit is billed as 99212 Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: A problem focused history; A problem focused examination; Straightforward medical decision making.

What is the correct CPT code for breast implant?

In this case, the physician removed the tissue expander and exchanged it for an implant in a straightforward fashion, without any extra work done to the breast or the capsule. CPT® 11970 is the correct code for this procedure.

What is CPT code 11970?

CPT code 11970 alone does not account for this additional work, which is over and above removal of an expander and replacement with a permanent implant. The provider should document if the capsule was particularly thick or tight to support the extra effort involved for billing the higher service.

What happens when you replace a tissue expander?

When the tissue expander is replaced, it may be that the capsule is found to be very tight and multiple radial incisions may be required in the capsule to accommodate the permanent prosthesis and form a symmetric contour to the opposite breast.

What is the code for a nipple tattoo?

Because nipple tattooing is calculated based on the total size of the areas, this is coded as 11921 and 11922. Because many payers reimburse breast reconstruction services only in relation to breast cancer, it’s prudent for providers to document current or past history of breast cancer in the operative report.

Why is code 19342 appropriate?

Code 19342 would be appropriate due to the extra amount of work involved with the surgery.

What is CPT 19357?

CPT® 19357 Breast reconstruction, immediate or delayed , with tissue expander, including subsequent expansion describes this first stage. The use of a dermal matrix, such as AlloDerm®, facilitates a higher initial expansion and is additionally billable with add-on code +15777 Implantation of biologic implant (eg, acellular dermal matrix) for soft tissue reinforcement (eg, breast, trunk) (List separately in addition to code for primary procedure).