CPT Knowledgebase - Jan 25, 2013

The August 2005 edition of the CPT Assistant (page 2) included the reporting of temporary tissue expander replacement, as excerpted: If a temporary tissue expander has been used, it is removed after the skin has stretched sufficiently and is replaced with a permanent breast prosthesis during a second operation. This procedure is generally coded [with code] 11970, Replacement of tissue expander with permanent prosthesis. Code 11970 is a global service and includes removal of the temporary expander, which is not to be reported separately. In certain instances, considerable capsular adjustments are necessary to allow proper placement of the prosthesis within the fibrous capsule that has formed around the expander, and with appropriate documentation in the operative report, code 19342 is sometimes used instead of 11970. Would the reference to the considerable capsular adjustments involve capsulotomy or capsulectomy for which code 11970 may be reported in addition to code 19371, Periprosthetic capsulectomy, breast?

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