AHA Coding Clinic® for HCPCS - 2022 Issue 4; Ask the Editor

Breast nipple reconstruction with biological cylinders

A patient with a history of bilateral mastectomies and breast reconstruction due to cancer presents for bilateral nipple reconstruction. Incisions were made on the right and left breasts to create C-V shaped flaps. To maintain a deeper plane into the subcutaneous tissue, the flaps were elevated peripherally and centrally. The lateral wings were trimmed and brought around to the center creating the nipple cylinders, which were secured with sutures. The biologic implants were brought onto the surgical field, placed within the created nipple cylinders and secured to the top and bottom via sutures. The tops of the nipple flaps were secured over the implants. Symmetry was maintained as much as possible. The dermis and skin were closed.Would placement of the nipple cylinder implants be considered an inclusive component of the nipple reconstruction surgery (19350) or considered a biologic implant (15777) for soft tissue reinforcement? How would the cylinder implants be reported if it were neither of these options? Would HCPCS code C1763, Connective tissue, nonhuman (includes synthetic), be reported for each cylinder implant device? ...

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