What is the appropriate code to report a skin-sparing mastectomy? How is the work of sparing the nipple reflected?
Answer: When the physician describes a skin-sparing mas-tectomy, he or she is performing a subcutaneous mastecto-my, CPT code 19304, Mastectomy, subcutaneous, to remove the breast but spare the skin. The nipple sparing has to do with the location of the tumor and whether it is far enough away from the nipple and does not change the subcutaneous dissection performed. Sparing the nipple is sometimes difficult because an inadequate blood supply may lead to its future loss. If the surgeon believes more work is required to spare the nipple, modifier 22, Increased procedural services, may be appended with submission of an operative report to document the extra work involved
Answer: When the physician describes a skin-sparing mas-tectomy, he or she is performing a subcutaneous mastecto-my, CPT code 19304, Mastectomy, subcutaneous, to remove the breast but spare the skin. The nipple sparing has to do with the location of the tumor and whether it is far enough away from the nipple and does not change the subcutaneous dissection performed. Sparing the nipple is sometimes difficult because an inadequate blood supply may lead to its future loss. If the surgeon believes more work is required to spare the nipple, modifier 22, Increased procedural services, may be appended with submission of an operative report to document the extra work involved
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