CPT® 2021: Master New Breast Reconstruction/Repair Guidelines

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

Article Overview

This article reviews CPT® 2021 breast reconstruction and repair guidance for surgeons, coders, and reimbursement professionals. It explains the broad structure of the updated guidance, including post-mastectomy reconstruction, native breast alteration, flap-based reconstruction, and related revision or ancillary procedures. The discussion is intended to help readers understand what topics the new guidance addresses and how the article is organized.

Why This Topic Matters

Breast reconstruction and repair cases often involve multiple linked procedures, and the CPT® 2021 guidance changes how these services are grouped and discussed. Understanding the scope of the update helps coders determine whether the article is relevant to their work and identify the procedure categories covered.

Article Sections

  1. Understanding 2 Reconstruction Categories

    Introduces the two broad categories used to organize breast reconstruction guidance and frames the overall scope of the article.

  2. Focus Post Mastectomy Implant Coding

    Covers implant-related post-mastectomy reconstruction topics and the related CPT® 2021 guidance discussed in the article.

  3. Distinguish Post Mastectomy Autologous Reconstruction

    Reviews flap-based breast reconstruction topics and the major code families highlighted in the updated guidance.

  4. Check Out Native Breast Alteration

    Summarizes the article’s discussion of procedures used to alter the native breast for symmetry or defect correction.

  5. Don’t Miss Additional Procedures

    Covers additional reconstruction-related services and revision topics addressed by the article, including ancillary procedures and broader guidance on related work.

What You Will Learn

  • How the article groups breast reconstruction guidance into major categories
  • Which general procedure types are discussed for post-mastectomy reconstruction
  • What kinds of flap-based and implant-based revision topics are included
  • Which ancillary services are addressed alongside breast reconstruction
  • How the article frames the CPT® 2021 update for breast reconstruction and repair

Who Should Read This

  • Medical coders
  • Coding auditors
  • Revenue cycle professionals
  • General surgery billing staff
  • Plastic surgery billing staff

Codes Discussed

Code Ranges Discussed

  • CPT: 15771, +15772
  • CPT: 14000, 14001
  • CPT: 15100, +15101
  • CPT: 15200, +15201
  • CPT: 11920, 11921, +11922

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