Tissue Expander Exchange with Breast Reconstruction Revision

Question:

At the time of the second stage tissue expander exchange, my plastic surgeon wants to bill 19380 for either liposuction, removing excess scar tissue, removing redundant excess skin or removing adipose tissue. “The lateral aspect of the mastectomy scar is excised along with redundant skin and subcutaneous tissue to revise the reconstructed right breast.” Can 11970 and 19380 be billed together?

Answer:

CPT states that 19380 may be reported for breast revision after reconstruction has taken place. At the time of a 2nd stage, expander to implant procedure, the reconstruction is just now being finalized. Therefore, 19380 would not be reported with 11970 for the same breast. If the expander to implant procedure is more extensive, due to the reasons you list, then you could potentially report 19342 instead of 11970.

*This response is based on the best information available as of 09/03/20.