Category: CC-Plastic Surgery

Denial of Breast Reconstruction
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Denial of Breast Reconstruction

August 19, 2021 Question: We received a denial for 19357-50 (tissue expander reconstruction) and +15777 x 2 units. The denial reason was “the diagnosis code and CPT code combination is inappropriate”. We used a diagnosis of C50.911 (Malignant neoplasm of unspecified site of right female breast). What diagnosis code(s) should we have used? Answer: For...

Use of Cadaver Cartilage
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Use of Cadaver Cartilage

July 8, 2021 Question: We have a patient that needs a major revision rhinoplasty requiring cadaver cartilage. There is no remaining local cartilage that can be utilized in this case and my surgeon has opted to use cadaver instead of rib cartilage. I know local grafts are not separately reportable, but is there a way...

Denial of 15839 with 19342
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Denial of 15839 with 19342

May 13, 2021 Question: My doctor performed 19342 (exchange of larger implant to smaller implant), 15771 (grafting of autologous fat) and 15839 (excision of excessive skin). We were denied for 15839 and I have sent a corrected claim with updated diagnosis codes for 15839 but the claim was again denied. Can you help please? Answer:...

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