Can 11970 and 19370 be billed together?
The updated guidelines for 2021 instruct providers to use CPT code 11970 together with CPT code 19370 (Revision of peri-implant capsule, breast, including capsulotomy, capsulorrhaphy, and/or partial capsulectomy) in that scenario.
What does CPT 11970 include?
Code 11970 is a global service and includes removal of the temporary expander, which is not to be reported separately.
Does CPT 11970 include capsulotomy?
The exchange of the tissue expander for a permanent implant requires a capsulotomy so the only code for that procedure is 11970 (not 19340, 19370, 19380). The fat grafting may be separately reported using 20926 which includes the harvest and placement/injection of the fat into the defect.
What does CPT 19328 include?
CPT® 19328, Under Repair and/or Reconstruction Procedures on the Breast. The Current Procedural Terminology (CPT®) code 19328 as maintained by American Medical Association, is a medical procedural code under the range – Repair and/or Reconstruction Procedures on the Breast.
What is the difference between CPT code 19370 and 19371?
A CPT Assistant newsletter states “A capsulectomy (CPT code 19371) involves removal of the capsule. The implant is also removed and may or may not be replaced.” Therefore, CPT 19370 (capsulotomy) is included in 19328 when performed to remove the implant.
What is included in CPT 19380?
Revision of reconstructed breast
Answer: CPT code 19380, Revision of reconstructed breast involves revising an already reconstructed breast. The code includes repositioning the breast; making adjustments to the inframammary crease; making capsular adjustments; and performing scar revisions, fat grafting, liposuction, and so on.
What does CPT 19380 include?
CPT 19380 is used when a revision is made to an already reconstructed breast that includes significant removal of tissue; re-ad- vancement and/or re-inset of flaps in autol- ogous reconstruction; or significant capsular revisions combined with soft-tissue excision in implant-based reconstruction.
What is included in CPT 19316?
or Reconstruction Procedures
CPT® 19316 in section: Repair and/or Reconstruction Procedures on the Breast.
What does CPT code 19370 include?
What does CPT 19366 include?
CPT® Code 19366 – Repair and/or Reconstruction Procedures on the Breast – Codify by AAPC.
What’s the difference between CPT 19328 and 19370?
Code 19370 cannot be reported in conjunction with CPT 19328 for removal and replacement of the same implant to access the capsule. Code 11971 – Removal of a tissue expander. The only change for code 11971 is that the word “prosthesis” has been replaced by “permanent implant”.
When to report CPT code 19342 or 11971?
When placing a new implant, code 19342 can be separately reported. if the capsular work performed is significant, code 19370 can be reported with tissue expander exchange. Code 19370 cannot be reported in conjunction with CPT 19328 for removal and replacement of the same implant to access the capsule. Code 11971 – Removal of a tissue expander.
When to use code 19370 for capsulorraphy?
The important change for code 19370 is that in addition to being used for capsulotomies, it is also used to report revisions of peri-implant capsule including capsulotomy, capsulorraphy and/or partial capsulectomy.
Is the periprosthetic capsulotomy 19370 an inclusive procedure?
Provider does open periprosthetic capsulotomy 19370 w/ removal of expander exhcange w/ permanent prosthesis 11970. bcbs denies the expander as inclusive. Are the two procedures typically bundled?