tci Outpatient Facility Coding Alert - 2016 Issue 9

Reader Question: Explore Your Options in Coding Breast Implants

Question: The provider performs subcutaneous mastectomy of the right breast, and inserts an implant as well. How do we code for this scenario? Texas Subscriber Answer: Subcutaneous mastectomy is a lesser known term as compared to partial or radical mastectomy. This is a skin sparing removal of the entire breast tissue, through an incision under the breast, sparing the breast skin, nipple and areola, in case these structures are not affected by the cancer spread. The right code for this would be 19304 (Mastectomy, subcutaneous). In this case, the provider does not remove the pectoralis major, pectoralis minor as...

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