Overview of CPT Code 19360: Breast Reduction Surgery
Breast reduction surgery, coded as CPT 19360, is a surgical procedure aimed at reducing the size of large breasts to alleviate physical discomfort and improve aesthetic appearance.
When CPT Code 19360 is Used?
Breast reduction surgery is indicated in various clinical scenarios.
- Severe back, neck, or shoulder pain due to breast weight.
- Skin irritation or rashes under the breasts.
- Difficulty in physical activities or exercise.
- Psychological distress related to breast size.
Symptoms Indicating This Procedure
Patients often report specific symptoms that may lead to the consideration of breast reduction surgery.
- Chronic pain in the back, neck, or shoulders.
- Skin rashes or irritation beneath the breasts.
- Difficulty finding properly fitting clothing.
- Emotional distress or self-consciousness about breast size.
Causes and Risk Factors
Several factors can contribute to the need for breast reduction surgery.
- Genetics leading to larger breast size.
- Hormonal changes during puberty, pregnancy, or menopause.
- Obesity or significant weight fluctuations.
Diagnostic Tests Before Procedure
Certain tests may be conducted to ensure the patient is a suitable candidate for surgery.
- Physical examination to assess breast size and shape.
- Imaging studies like mammograms if indicated.
Procedure Description
The breast reduction surgery involves several key steps.
- Anesthesia is administered to ensure patient comfort.
- Incisions are made, typically around the areola and down the breast.
- Excess breast tissue, fat, and skin are removed.
- The remaining breast tissue is reshaped and the incisions are closed.
Preparation for the Procedure
Patients should follow specific guidelines to prepare for breast reduction surgery.
- Consult with the surgeon about medical history and medications.
- Avoid smoking and certain medications that can increase bleeding.
- Arrange for transportation to and from the surgery.
Recovery and Aftercare
Post-operative care is crucial for a smooth recovery.
- Rest for several days following the surgery.
- Wear a supportive bra as recommended by the surgeon.
- Follow up for suture removal and check-ups as scheduled.
Possible Complications
As with any surgery, there are potential risks involved.
- Infection at the incision site.
- Scarring or changes in breast sensation.
- Asymmetry in breast size or shape.
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Post-Procedure Follow-Up
Regular follow-up appointments are essential for monitoring recovery.
- Initial follow-up within a week to check healing.
- Subsequent visits at 1 month, 3 months, and 6 months post-surgery.
Alternative Treatments
Non-surgical options may be considered before opting for surgery.
- Physical therapy to strengthen back and shoulder muscles.
- Weight loss programs to reduce breast size.
- Supportive bras to alleviate discomfort.
Home Care Tips
Patients can take steps at home to aid recovery.
- Keep the surgical area clean and dry.
- Avoid strenuous activities for several weeks.
- Take prescribed medications as directed.
Patient Education & Prevention
Understanding the procedure and its implications can help in decision-making.
- Discuss all concerns with the surgeon before surgery.
- Understand the potential for future breast changes.
- Maintain a healthy lifestyle to prevent recurrence of symptoms.
Billing and Coding Information
CPT Code: 19360
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 $10,000.
- Many insurance plans cover the procedure if medically necessary.
Related CPT Codes
- 19361 - Breast Reconstruction with Implant
- 19302 - Breast Reconstruction with Implant
- 19303 - Breast Reconstruction with Implant
- 19304 - Breast Reconstruction with Implant
- 19305 - Breast Reconstruction with Implant
References and Sources
Frequently Asked Questions (FAQs)
What is breast reduction surgery?
It is a surgical procedure to remove excess breast tissue and skin.
How long is the recovery period?
Most patients take about 4 to 6 weeks to fully recover.
Will insurance cover the procedure?
Insurance may cover it if deemed medically necessary.
Are there risks involved?
Yes, like any surgery, there are risks such as infection and scarring.
