Breast Reconstruction Coding

March 1, 2008

I need to bill a breast reconstruction using a latissimus dorsi muscle flap and insertion. Should it be coded 19361 (LD flap w/o prosthetic device) alone, or should I also add 19357-51 (insertion of tissue expander)?

Question: I need to bill a breast reconstruction using a latissimus dorsi muscle flap and insertion. Should it be coded 19361 (LD flap w/o prosthetic device) alone, or should I also add 19357-51 (insertion of tissue expander)?

Answer: CPT code 19361 is mutually exclusive to 19357 in NCCI so you should code only the 19361.