Overview of CPT Code 19368: Breast Reconstruction with Tissue Expander
CPT Code 19368 refers to the surgical procedure of breast reconstruction using a tissue expander. This technique is often employed after mastectomy to restore breast shape and volume.
When CPT Code 19368 is Used?
This procedure is indicated in various clinical scenarios.
- Post-mastectomy breast reconstruction for patients with breast cancer.
- Reconstruction after lumpectomy when significant tissue loss occurs.
- Patients seeking to restore breast symmetry after unilateral mastectomy.
Symptoms Indicating This Procedure
Patients may report several symptoms that lead to the consideration of this procedure.
- Loss of breast volume after mastectomy.
- Desire for improved breast contour and symmetry.
- Psychological distress related to body image after breast surgery.
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 deformities.
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 the diagnosis of breast cancer.
Procedure Description
The procedure involves several key steps.
- Anesthesia is administered to ensure patient comfort.
- The surgeon makes an incision to place the tissue expander beneath the chest muscle.
- The expander is filled with saline gradually over time to stretch the skin.
- Once the desired size is achieved, a second surgery is performed to replace the expander with a permanent implant.
Preparation for the Procedure
Patients should follow specific guidelines before the surgery.
- Consult with the surgeon about medical history and medications.
- Avoid blood thinners and certain supplements as advised.
- Arrange for post-operative transportation and support.
Recovery and Aftercare
Post-operative care is crucial for recovery.
- Initial recovery may take 1-2 weeks with limited activity.
- Wound care instructions should be followed to prevent infection.
- Pain management may include 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 implant.
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Post-Procedure Follow-Up
Regular follow-up is essential for monitoring recovery.
- Initial follow-up within 1-2 weeks post-surgery.
- Subsequent visits every few months to assess healing.
- Long-term follow-up to monitor implant condition and breast health.
Alternative Treatments
There are non-surgical options available.
- Prosthetic breast forms for external use.
- Fat grafting techniques to improve breast contour.
- 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 lifestyle changes that may reduce cancer risk.
- Regular screenings and self-exams for breast health.
Billing and Coding Information
CPT Code: 19368
Category: Surgery
Common Modifiers:
- 50
- RT
- LT
Average Cost and Insurance Coverage
Costs can vary based on several factors.
- Average cost ranges from $10,000 to $30,000.
- Insurance may cover the procedure if deemed medically necessary.
- Out-of-pocket costs depend on the insurance plan.
Related CPT Codes
- 19369 - Breast Reconstruction with Implant
- 19361 - Breast Reconstruction with Implant
- 19364 - Breast Reconstruction with Implant
- 19370 - Breast Reconstruction with Tissue Expander
References and Sources
Frequently Asked Questions (FAQs)
What is a tissue expander?
A tissue expander is a device used to stretch the skin and create space for a permanent breast implant.
How long does the procedure take?
The surgery typically lasts 1 to 3 hours, depending on individual circumstances.
Will I have scars after the surgery?
Yes, there will be scars, but they usually fade over time.
How long is the recovery period?
Most patients take about 1-2 weeks to recover before returning to normal activities.
