Reporting Breast Reconstruction Codes (August 2005)

Why This Topic Matters

Breast reconstruction often involves multiple procedures and postoperative components that must be reported consistently. Understanding the structure of the CPT codes and related modifier use helps support accurate surgical reporting and claims submission.

Article Sections

1. Introduction

   Provides an overview of breast reconstruction after mastectomy and distinguishes major reconstruction approaches. It also introduces the article’s focus on coding categories and inclusive elements.

2. Timing

   Discusses immediate and delayed reconstruction in relation to procedure reporting. It frames how timing interacts with the main categories of breast reconstruction coding.

3. Prosthesis or Implant

   Reviews implant-based reconstruction at the time of mastectomy and at a later date. It also addresses the related CPT identifiers used for these services.

4. Tissue Expansion

   Covers the use of tissue expansion in breast reconstruction and the associated global service concepts. The section also notes postoperative and replacement-related considerations.

5. Flaps

   Summarizes flap-based breast reconstruction and the elements included in the global codes. It distinguishes among major flap categories and related microsurgical components.

6. Unilateral or Bilateral Procedures

   Explains how laterality is handled for breast reconstruction reporting. It also discusses bilateral reporting at the same operative session.