Coding Breast Implant Revision Surgeries (August 1996)

August 1996 page 8 Coding Communication Coding Breast Implant Revision Surgeries We receive many questions about correct CPT coding for breast implant revision surgeries. Specifically, many coders are confused about coding the removal and reinsertion of breast implants. Recently, these issues were addressed by members of the CPT Editorial Panel and Advisory Committee. Common Questions I have heard from some coding sources that 19371 and 19340 should be bundled. For some patients, I perform a periprosthetic capsulectomy, remove the patient's old breast implant, and then insert a new breast implant. What CPT codes should I report? CPT code 19371...

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Note:  The following article synopsis was NOT provided by the AMA. It was created by Find-A-Code/innoviHealth.

Article Overview

This CPT Assistant article addresses common breast implant revision and reconstruction coding questions from August 1996. It focuses on how to think about related breast prosthesis, capsular, and flap procedures, and it discusses when separate reporting may be appropriate under CPT guidance. The article is useful for coders working in plastic surgery, breast reconstruction, and surgical billing who need to understand the scope of the guidance discussed by the CPT Editorial Panel and Advisory Committee.

Why This Topic Matters

Breast implant revision and reconstruction cases can involve multiple related procedures in one operative session. Understanding the article helps coders review the coding topics, procedure groupings, and CPT references discussed in this era of guidance.

Article Sections

  1. Coding Communication / Common Questions

    Introduces the coding questions addressed in the article and frames the main breast implant revision and reconstruction topics discussed.

  2. Breast implant removal, capsulectomy, and reinsertion

    Covers the general relationship between capsular procedures, implant removal, and prosthesis reinsertion as discussed in the article.

  3. Breast reconstruction using the Ryan technique or a thoracoepigastric flap

    Discusses reconstruction approaches involving additional flap work and prosthesis insertion, along with related CPT references.

  4. Breast reconstruction with free flap

    Addresses the reporting of breast reconstruction with free flap techniques and the separate flap procedure concept referenced in the article.

  5. Immediate versus delayed insertion of a breast prosthesis

    Explains the article’s distinction between timing-based categories of prosthesis insertion in breast surgery coding.

What You Will Learn

  • The main coding topics discussed for breast implant revision surgery
  • How the article frames combined breast reconstruction and flap procedures
  • The timing concepts used for prosthesis insertion coding
  • Which CPT references are discussed in relation to breast implant revision scenarios

Who Should Read This

  • Medical coders
  • Coding auditors
  • Plastic surgery billers
  • Revenue cycle staff
  • Breast reconstruction surgery practices

Codes Discussed

  • CPT: 19371
  • CPT: 19340
  • CPT: 19370
  • CPT: 19342
  • CPT: 14001
  • CPT: 14300
  • CPT: 19366
  • CPT: 19364
  • CPT: 15734

Modifiers Discussed

  • CPT: -51

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