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Overview of CPT Code 19254:Placement of Breast Tissue Expander

Overview of CPT Code 19254:Placement of Breast Tissue Expander

CPT Code 19254 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 19254 is Used?

This procedure is indicated in several clinical scenarios.

  • Post-mastectomy breast reconstruction.
  • Breast reconstruction after lumpectomy.
  • Patients desiring breast augmentation after significant weight loss.
  • Correction of breast asymmetry.

Symptoms Indicating This Procedure

Patients may present with various symptoms that lead to the need for this procedure.

  • Loss of breast tissue due to cancer treatment.
  • Desire for breast reconstruction after mastectomy.
  • Physical discomfort or psychological distress related to breast appearance.

Causes and Risk Factors

Several factors may lead to the need for a breast tissue expander.

  • Breast cancer requiring mastectomy.
  • Genetic predisposition to breast cancer.
  • Previous breast surgeries that altered breast structure.

Diagnostic Tests Before Procedure

Prior to the procedure, certain diagnostic tests may be performed.

  • Mammography to assess breast tissue.
  • Ultrasound for evaluation of breast masses.
  • MRI for detailed imaging of breast anatomy.

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 beneath the breast tissue or chest muscle.
  • Insert the tissue expander and secure it in place.
  • 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 to and from the procedure.

Recovery and Aftercare

Post-operative care is crucial for recovery.

  • Rest for several days following the procedure.
  • Follow wound care instructions to prevent infection.
  • Attend follow-up appointments for monitoring and expansion of the tissue expander.

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.
  • Displacement or rupture of the expander.
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Post-Procedure Follow-Up

Regular follow-up is essential for optimal recovery.

  • Initial follow-up within one week post-surgery.
  • Subsequent visits every few weeks for tissue expansion.
  • Long-term follow-up to assess the final outcome.

Alternative Treatments

There are non-surgical options available.

  • Prosthetic breast forms for external use.
  • Fat grafting techniques for breast reconstruction.
  • Psychological counseling for body image issues.

Home Care Tips

Patients can take steps to aid their recovery at home.

  • Keep the surgical area clean and dry.
  • Wear a supportive bra as recommended.
  • Avoid strenuous activities until cleared by the surgeon.

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-examinations.

Billing and Coding Information

CPT Code: 19254

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.
  • Insurance may cover the procedure if deemed medically necessary.
  • Out-of-pocket costs depend on the insurance plan and deductible.

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 to prepare 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 soon can I return to normal activities?

Most patients can return to normal activities within a few weeks, but follow your surgeon's advice.

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