Capsulectomy and Revision of Breast Reconstruction

September 29, 2016

Question:
My doctor did a partial capsulectomy to revise the inframammary fold as well as fat grafting to some defects on a reconstructed breast. Additionally, he revised the scar and took off some excess lateral breast tissue. We submitted the following codes: 19380, 19371-59, 20926-59, and 15839-59. We only got paid on 19380. I have appealed the denial twice but no luck. Can you please help?

Answer:
Sorry – can’t help! Actually, all the procedures you performed are covered in one code, 19380 (Revision of reconstructed breast).

*This response is based on the best information available as of 09/29/16.

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