Removal of Tissue Expander in the Office

Question:

I have a question on tissue expander coding. How would I code for an in office procedure on a tissue expander removal under local anesthesia? The patient had breast cancer and the mastectomy was performed at a different facility. The patient’s tissue expander became exposed so the expander was removed at my facility in the office. I was trying to find some coding guidelines on this scenario. Any help you can give me would be greatly appreciated!

Answer:

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). Medicare’s payment for the physician in the office (place of service 11) is somewhat higher than the payment in the OR (place of service 24, 22, 21).

*This response is based on the best information available as of 01/18/18.