Overview of CPT Code 19366: Breast Reconstruction with Tissue Expander
CPT Code 19366 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 device under the skin to gradually expand the breast tissue, allowing for the eventual placement of a permanent implant.
When CPT Code 19366 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 injury.
- Desire for breast symmetry after surgical removal.
- Psychological distress related to breast loss.
- Physical discomfort from uneven breast contour.
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 before surgery.
- Mammography to assess breast tissue.
- MRI for detailed imaging of breast anatomy.
- Biopsy to confirm the presence of cancer.
- 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 muscle.
- Gradually fill the expander with saline over several weeks.
- Once the desired size is achieved, schedule for implant placement.
Preparation for the Procedure
Patients should follow specific guidelines before surgery.
- Consult with the surgeon about medical history and medications.
- Stop smoking and avoid blood thinners as advised.
- Arrange for transportation to and from the procedure.
- Follow dietary restrictions as instructed.
Recovery and Aftercare
Post-operative care is crucial for healing.
- Expect swelling and bruising in the breast area.
- Follow up with the surgeon for wound checks.
- Manage pain with prescribed medications.
- Avoid strenuous activities for several weeks.
Possible Complications
As with any surgery, there are potential risks.
- 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 implant placement.
- Long-term follow-up to monitor breast health.
Alternative Treatments
There are non-surgical options available.
- Prosthetic breast forms for external support.
- Psychological counseling for emotional support.
- Physical therapy to improve body image and confidence.
Home Care Tips
Patients can take steps to aid recovery at home.
- Keep the surgical area clean and dry.
- Wear a supportive bra as recommended.
- Avoid lifting heavy objects.
- Stay hydrated and maintain a balanced diet.
Patient Education & Prevention
Education is key to preventing complications.
- Understand the signs of infection and when to seek help.
- Discuss genetic testing options if at high risk for breast cancer.
- Regular self-exams and mammograms as recommended.
Billing and Coding Information
CPT Code: 19366
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.
- Verify coverage details with your insurance provider.
Related CPT Codes
- 19367 - Breast Reconstruction with Implant
- 19368 - Breast Reconstruction with Tissue Expander
- 19361 - Breast Reconstruction with Implant
- 19364 - Breast Reconstruction with Implant
- 19355 - Breast Reconstruction with Implant
References and Sources
Frequently Asked Questions (FAQs)
What is a tissue expander?
A tissue expander is a device used to stretch the skin and muscle to create space for a permanent breast implant.
How long does the procedure take?
The procedure typically takes 1 to 2 hours, depending on individual circumstances.
Will I have scars after surgery?
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 4 to 6 weeks.
