Overview of CPT Code 19370:Breast Reconstruction with Tissue Expander
CPT Code 19370 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, allowing for a more natural appearance.
When CPT Code 19370 is Used?
This procedure is indicated in several clinical scenarios.
- Post-mastectomy breast reconstruction for patients with breast cancer.
- 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 volume or shape due to mastectomy.
- Asymmetry in breast appearance.
- Psychological distress related to breast loss.
- Desire for improved body image and self-esteem.
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 deformity.
- 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 a tissue expander beneath the skin and muscle.
- Gradually fill the expander with saline over time to stretch the skin.
- Monitor the expander for proper placement and adjust as necessary.
Preparation for the Procedure
Patients should follow specific guidelines before surgery.
- Consult with the surgeon to discuss expectations and risks.
- Avoid blood thinners and certain medications as advised.
- Arrange for transportation to and from the procedure.
- Follow dietary restrictions as instructed prior to surgery.
Recovery and Aftercare
Post-operative care is crucial for healing.
- Expect swelling and discomfort in the surgical area.
- Follow wound care instructions to prevent infection.
- Attend follow-up appointments for monitoring.
- Manage pain with prescribed medications as needed.
Possible Complications
Like any surgical procedure, there are risks involved.
- Infection at the surgical site.
- Bleeding or hematoma formation.
- Tissue expander complications (e.g., rupture, displacement).
- Scarring or changes in breast sensation.
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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 to monitor the expander.
- Long-term follow-up to assess final reconstruction results.
Alternative Treatments
There are non-surgical options available.
- Prosthetic breast forms for external support.
- Fat grafting techniques for volume restoration.
- Psychological counseling for emotional support.
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.
- Limit physical activity to avoid strain on the surgical site.
- 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 options for genetic testing if at risk for breast cancer.
- Maintain regular screenings for breast health.
Billing and Coding Information
CPT Code: 19370
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 may cover the procedure if deemed medically necessary.
- Out-of-pocket costs depend on the patient's insurance plan.
Related CPT Codes
- 19371 - Breast Reconstruction with Tissue Expander
- 19368 - Breast Reconstruction with Tissue Expander
- 19364 - Breast Reconstruction with Implant
- 19369 - 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 create space for a permanent implant.
How long does the recovery take?
Recovery can take several weeks, with full healing taking a few months.
Will I have visible scars?
Scarring is possible, but techniques can minimize their appearance.
Is the procedure painful?
Some discomfort is expected, but pain can be managed with medication.
