Placement of Alloderm for Breast Reconstruction

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Question:

I’ve always used 15330 (placement of acellular dermal graft) for placing AlloDerm with my tissue expander reconstructions. All of a sudden, the code is being denied by the payors. Help!

Answer:

As of January 1, 2012, CPT directs physicians to now use the add-on code 15777 (Implantation of biologic implant (eg, acellular dermal matrix) for soft tissue reinforcement (eg, breast, trunk) (List separately in addition to code for primary procedure)) for this activity. CPT 15777 may be reported with modifier 50 (bilateral procedure) when appropriate. Remember, the code is an add-on code and should not be reported with modifier 51 (multiple procedures) and payment for the code should be 100% of the allowable.