Overview of CPT Code 19362: Breast Reconstruction with Tissue Expander
CPT Code 19362 refers to the surgical procedure of breast reconstruction using a tissue expander, typically performed after mastectomy due to breast cancer or other conditions. This method involves placing a temporary device under the skin to gradually expand the breast tissue, allowing for the eventual placement of a permanent implant.
When CPT Code 19362 is Used?
This procedure is indicated in several clinical scenarios.
- Post-mastectomy breast reconstruction for breast cancer patients.
- Reconstruction after lumpectomy when significant tissue loss occurs.
- Correction of congenital breast deformities.
- Reconstruction following trauma or injury to the breast.
Symptoms Indicating This Procedure
Patients may report various symptoms that lead to the need for this procedure.
- Loss of breast tissue due to mastectomy or lumpectomy.
- Desire for breast symmetry after surgical removal.
- Psychological distress related to breast loss.
- Physical discomfort from the absence of breast tissue.
Causes and Risk Factors
Several factors can lead to the need for breast reconstruction.
- Breast cancer requiring mastectomy.
- Genetic predisposition to breast cancer (e.g., BRCA mutations).
- Previous breast surgeries that resulted in tissue loss.
- Radiation therapy affecting breast tissue.
Diagnostic Tests Before Procedure
Certain tests are essential to evaluate the patient's condition prior to surgery.
- Mammography to assess breast tissue.
- MRI for detailed imaging of breast anatomy.
- Biopsy to confirm cancer diagnosis.
- Blood tests to evaluate overall health.
Procedure Description
The procedure involves several key steps.
- Administer anesthesia to ensure patient comfort.
- Make an incision in the breast area.
- Place the tissue expander under the skin and chest muscle.
- Gradually fill the expander with saline over several weeks.
- Monitor the expansion process and adjust as necessary.
Preparation for the Procedure
Patients should follow specific guidelines before surgery.
- Consult with the surgeon to discuss expectations.
- Stop smoking and avoid blood thinners as advised.
- Arrange for post-operative transportation.
- Follow dietary restrictions prior to surgery.
Recovery and Aftercare
Post-operative care is crucial for healing.
- Expect swelling and discomfort for several days.
- Follow-up appointments to monitor healing.
- Keep the surgical area clean and dry.
- Take prescribed pain medications as needed.
Possible Complications
Like any surgery, there are potential risks involved.
- Infection at the surgical site.
- Bleeding or hematoma formation.
- Capsular contracture around the expander.
- Delayed healing or tissue necrosis.
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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 during expansion.
- Final assessment before permanent implant placement.
Alternative Treatments
There are non-surgical options available.
- Prosthetic breast forms for external use.
- Psychological counseling for emotional support.
- Physical therapy to improve body image.
Home Care Tips
Patients can take steps to aid their recovery at home.
- Wear a supportive bra as recommended.
- Avoid strenuous activities for several weeks.
- Keep the surgical area clean and monitor for signs of infection.
- Stay hydrated and maintain a balanced diet.
Patient Education & Prevention
Education is key to preventing complications.
- Understand the importance of follow-up care.
- Be aware of signs of infection or complications.
- Discuss any concerns with healthcare providers promptly.
- Consider genetic counseling if there is a family history of breast cancer.
Billing and Coding Information
CPT Code: 19362
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 $10,000 to $30,000.
- Insurance often covers reconstruction after mastectomy.
- Out-of-pocket costs depend on the insurance plan.
Related CPT Codes
- 19361 - Breast Reconstruction with Implant
- 19357 - Breast Reconstruction with Tissue Expander
- 19368 - Breast Reconstruction with Tissue Expander
- 19303 - Breast Reconstruction with Implant
- 19340 - Breast Reconstruction with Implant
References and Sources
Frequently Asked Questions (FAQs)
What is a tissue expander?
A tissue expander is a temporary device used to stretch the skin and muscle to create space for a permanent breast implant.
How long does the recovery take?
Most patients can expect a recovery period of 4 to 6 weeks before returning to normal activities.
Will insurance cover this procedure?
Many insurance plans cover breast reconstruction after mastectomy, but it's best to check with your provider.
Are there any risks involved?
As with any surgery, there are risks such as infection, bleeding, and complications with the expander.
How is the expander filled?
The expander is filled with saline through a port that is accessed with a needle during follow-up visits.
