Category: CC-Plastic Surgery

Breast Biopsy
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Breast Biopsy

March 19, 2020 Question: I did a biopsy of the breast defect before doing the reconstruction. Can I also code for the breast biopsy? Answer: A biopsy from the same surgical location as a primary procedure (breast reconstruction) is not separately reported. *This response is based on the best information available as of 03/19/20.  

Are Pre-Op Visits Billable?
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Are Pre-Op Visits Billable?

February 20, 2020 Question: For patients that are having surgery that day, I’ve been doing pre-op visits that morning (coming in earlier), and not doing a preop visit in clinic the week before surgery. Can I bill a follow up visit for the meeting/note (H&P) that occurs the morning of surgery? Answer: No – a...

Laceration and Fracture Repair
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Laceration and Fracture Repair

January 23, 2020 Question: My physician is utilizing an open laceration on the patient’s chin for open reduction of a mandibular symphysis fracture and he wants to also charge for a complex laceration repair for that laceration. Is this billable or is it part of the ORIF code? Answer: If the fracture is repaired through...

Implantation of Biologic Implants
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Implantation of Biologic Implants

December 19, 2019 Question: Can we use 15777 Implantation of biologic implant (e.g. acellular dermal matrix) for soft tissue reinforcement for other tissues beside the breast or trunk? Answer: Code 15777 specifically points to breast and/or trunk only, as “i.e.” stands for “in other words”. Report code 17999 Unlisted procedure, skin, mucous membrane and subcutaneous...

Modifiers for Free Flap Breast Reconstruction
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Modifiers for Free Flap Breast Reconstruction

November 14, 2019 Question: Do the free flap breast reconstruction codes, 19364 and S2068, allow billing for surgeon, co-surgeon and assistant? Answer: CPT 19364 does allow payment for the surgeon, co-surgeon (modifier 62) and assistant surgeon (modifier 80, 82 and AS). However, many payors do not recognize modifiers 62, 80, 82 and/or AS on S2068....

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