Coding For Rib Resection

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Question:

I heard rumors that one should also code for a rib resection when performed with a DIEP flap breast reconstruction. Is this correct?

Answer:

No. CPT 19364 (Breast reconstruction with free flap) includes a partial rib resection (eg, 21600) so this should not be separately reported . Per CPT(R) guidelines, 19364 includes the elevation and transfer of flap, closure of donor site, breast contouring, microvascular transfer (identification, exploration, transfer and anastomosis of vessels), partial rib resection to access internal mammary vessels, use of the operative microscope, inset of flap and formation of breast mound as well as primary closure.