Overview of CPT Code 19216:Placement of breast tissue expander
CPT Code 19216 refers to the surgical procedure for the placement of a breast tissue expander, which is often used in breast reconstruction following mastectomy or lumpectomy. This procedure allows for gradual expansion of the breast tissue to accommodate a permanent implant.
When CPT Code 19216 is Used?
This procedure is indicated in several clinical scenarios.
- Breast reconstruction after mastectomy due to breast cancer.
- Reconstruction following lumpectomy for breast cancer.
- Correction of breast asymmetry.
- Preparation for permanent breast implants.
Symptoms Indicating This Procedure
Patients may present with various symptoms that lead to the need for this procedure.
- Desire for breast reconstruction after mastectomy.
- Physical discomfort or dissatisfaction with breast shape.
- Psychological distress related to breast loss.
Causes and Risk Factors
Several factors may lead to the need for a breast tissue expander.
- Diagnosis of breast cancer requiring mastectomy.
- Genetic predisposition to breast cancer.
- Previous breast surgeries that altered breast tissue.
Diagnostic Tests Before Procedure
Prior to the procedure, certain diagnostic tests may be performed.
- Mammography to assess breast tissue.
- MRI for detailed imaging of breast anatomy.
- Biopsy to confirm cancer diagnosis.
Procedure Description
The procedure involves several key steps.
- Administer anesthesia to the patient.
- Make an incision in the breast area.
- Create a pocket for the tissue expander.
- Insert the tissue expander into the pocket.
- Close the incision with sutures.
Preparation for the Procedure
Patients should follow specific guidelines before the procedure.
- Consult with the surgeon about medical history and medications.
- Avoid blood thinners and certain supplements as advised.
- Arrange for transportation post-surgery.
Recovery and Aftercare
Post-procedure recovery involves several considerations.
- Rest for a few days following the procedure.
- Follow wound care instructions to prevent infection.
- Manage pain with prescribed medications.
Possible Complications
As with any surgical procedure, there are potential risks.
- Infection at the surgical site.
- Bleeding or hematoma formation.
- Capsular contracture around the expander.
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Post-Procedure Follow-Up
Regular follow-up is essential for monitoring recovery.
- Initial follow-up within one week post-surgery.
- Subsequent visits every few weeks to monitor expansion.
- Long-term follow-up to assess overall breast reconstruction.
Alternative Treatments
There are non-surgical options available.
- Prosthetic breast forms for external use.
- Counseling and support groups for emotional support.
Home Care Tips
Patients can follow these tips for better recovery.
- Keep the surgical area clean and dry.
- Wear a supportive bra as recommended.
- Avoid strenuous activities until cleared by the doctor.
Patient Education & Prevention
Education is key to preventing complications.
- Understand the signs of infection and when to seek help.
- Discuss options for breast cancer screening and prevention.
- Stay informed about breast health and self-exams.
Billing and Coding Information
CPT Code: 19216
Category: Surgery
Common Modifiers:
- 50 (bilateral procedure)
- RT (right side)
- LT (left side)
Average Cost and Insurance Coverage
Costs can vary based on several factors.
- Average cost ranges from $5,000 to $15,000.
- Most insurance plans cover the procedure if medically necessary.
Related CPT Codes
- 19357 - Breast Reconstruction with Tissue Expander
- 19340 - Breast Reconstruction with Implant
- 19342 - Breast Reconstruction with Implant
- 19350 - Breast Reconstruction with Tissue Expander
- 19361 - Breast Reconstruction with Implant
References and Sources
Frequently Asked Questions (FAQs)
What is a breast tissue expander?
A breast tissue expander is a device used to stretch the skin and muscle in preparation for a permanent breast implant.
How long does the procedure take?
The procedure typically takes about one to two hours.
Will I have scars after the procedure?
Yes, there will be scars, but they usually fade over time.
How long is the recovery period?
Most patients can return to normal activities within a few weeks.
