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Question: How should I code the exchange of a tissue expander for a different type of tissue expander during the global period of the original reconstruction procedure? The surgeon performed a capsulotomy only for access to the expander.Vermont SubscriberAnswer: You should report 19371 (Periprosthetic capsulectomy, breast) and 19357 (Breast reconstruction, immediate or delayed, with tissue expander, including subsequent expansion). Modifier 78 (Unplanned return to the operating/procedure room by the same physician following initial procedure for a related procedure during the postoperative period) is probably appropriate on both codes, although you don't mention why the expander is being removed...
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