A post breast reconstruction/revision was performed using harvested fat. The patient has a history of breast cancer. According to the operative report fat was suctioned out and not harvested through an incision. Following this the fat was then injected into the breast. We assigned CPT 11950, Subcutaneous injection of filling material (eg, collagen; 1 cc or less, for the injection of autologous fat, but didn't have a CPT code for the harvesting, which I think should be an unlisted CPT code. Some of the coders reported this procedure with CPT code 19380, Revision of reconstructed breast, and now they decided that CPT code 20926 is a much better code. Would CPT 20926 be a more appropriate code because it requires the fat graft to be removed by incision? This is becoming a common type procedure, and we need help in determining how to assign the CPT code correctly.
Based on the operative report submitted, a small incision was created for the suctioning of the fat and stored in syringes until needed. The suctioned fat was then injected into the parenchyma of the right breast for symmetry and not for augmentation. Report CPT code 20926, Tissue grafts, other (eg, paratenon, fat, dermis) for the staged reconstruction with autologous fat. The injection of the autologous fat is included in CPT code 20926; therefore CPT code 11950 would not be reported.