Coding Guidelines for Reconstructive Surgery CPT Codes

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Coding Guidelines for Reconstructive Surgery CPT
Codes

• Reconstructive surgery is a specialized field
  that involves the restoration of the body's form
  and function following injury, disease, or
  congenital abnormalities. Accurate selection of
  reconstructive surgery CPT codes is essential to
  ensure proper reimbursement and compliance with
  coding regulations. Note that CPT is the
  copyright of the American Medical Association
  (AMA), so sharing the complete list of
  reconstructive surgery CPT codes is not possible.
  For basic understanding, we shared some of the
  most commonly used CPT codes for reconstructive
  surgery and their coding guidelines.
• Most Common Reconstructive Surgery CPT Codes
• CPT Codes 14000 14302
• CPT code range 14000 - 14302 is used for skin
  substitute procedures, including grafts and
  flaps, used to restore skin tissue loss due to
  injury or disease. Following are some guidelines
  on how to use these reconstructive surgery CPT
  codes
• Determine the type of skin substitute procedure
  being performed The codes in this range include
  various types of skin substitute procedures, such
  as split-thickness skin grafts, full-thickness
  skin grafts, and pedicle flaps. It is important
  to identify the specific procedure being
  performed in order to select appropriate code.

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Coding Guidelines for Reconstructive Surgery CPT
Codes

• Identify the size and location of the graft or
  flap The codes in this range are based on the
  size and location of the skin tissue being
  replaced. It is important to accurately measure
  the size of the graft or flap and document the
  location of the defect in order to select the
  appropriate code.
• Choose the appropriate code based on the size and
  location of the graft or flap Once the type of
  procedure and size and location of the graft or
  flap have been determined, the appropriate CPT
  code can be selected from the range of codes
  available.
• Use any necessary modifiers Depending on the
  circumstances of the procedure, it may be
  necessary to use modifiers to indicate additional
  information, such as whether the procedure was
  performed on multiple areas or whether it was a
  staged procedure.
• It is important to ensure that the CPT code
  accurately reflects the specific procedure
  performed in order to ensure proper reimbursement
  and compliance with coding regulations. It is
  recommended to consult with a qualified coding
  professional or dermatology expert for further
  guidance on the use of these codes.
• CPT Codes 19316 19396
• CPT code range 19316 - 19396 is used for breast
  reconstruction procedures, including
  implant-based and autologous tissue-based
  techniques, used to restore the form and function
  of the breast following a mastectomy. Following
  are some guidelines on how to use these
  reconstructive surgery CPT codes

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Coding Guidelines for Reconstructive Surgery CPT
Codes

• Determine the type of breast reconstruction
  procedure being performed The codes in this
  range include various types of breast
  reconstruction procedures, such as implant-based
  reconstruction and autologous tissue-based
  reconstruction using flaps. It is important to
  identify the specific procedure being performed
  in order to select the appropriate code.
• Identify whether the procedure is unilateral or
  bilateral The codes in this range are divided
  based on whether the breast reconstruction
  procedure is unilateral (one side) or bilateral
  (both sides). It is important to accurately
  document whether the procedure is being performed
  on one or both breasts in order to select the
  appropriate code.
• Choose the appropriate code based on the type and
  extent of the reconstruction Once the type of
  procedure and unilateral/bilateral nature of the
  procedure have been determined, the appropriate
  CPT code can be selected from the range of codes
  available based on the extent of the
  reconstruction.
• Use any necessary modifiers Depending on the
  circumstances of the procedure, it may be
  necessary to use modifiers to indicate additional
  information, such as whether the procedure was
  performed at the time of the mastectomy or
  whether it was a staged reconstruction.
• CPT Codes 21120 21299

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Coding Guidelines for Reconstructive Surgery CPT
Codes

• CPT code range 21120 - 21299 is used for nasal
  and facial bone reconstruction procedures,
  including rhinoplasty and orbital fracture
  repair, used to restore the form and function of
  the face following injury or disease. Following
  are some guidelines on how to use these
  reconstructive surgery CPT codes
• Determine the type of nasal or facial bone
  reconstruction procedure being performed The
  codes in this range include various types of
  nasal and facial bone reconstruction procedures,
  such as rhinoplasty, maxillofacial fracture
  repair, and orbital fracture repair. It is
  important to identify the specific procedure
  being performed in order to select the
  appropriate code.
• Identify the location and extent of the
  reconstruction The codes in this range are based
  on the location and extent of the nasal or facial
  bone reconstruction being performed. It is
  important to accurately document the location and
  extent of the reconstruction in order to select
  the appropriate code.
• Choose the appropriate code based on the specific
  procedure and extent of the reconstruction Once
  the type of procedure and location/extent of the
  reconstruction have been determined, the
  appropriate CPT code can be selected from the
  range of codes available based on the specific
  procedure and extent of the reconstruction.
• Use any necessary modifiers Depending on the
  circumstances of the procedure, it may be
  necessary to use modifiers to indicate additional
  information, such as whether the procedure was
  performed as a primary or revision procedure or
  whether it involved multiple procedures or sites.

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Coding Guidelines for Reconstructive Surgery CPT
Codes

• CPT Codes 29806 29827
• CPT code range 29806 - 29827 is used for shoulder
  reconstruction procedures, including rotator cuff
  repair and shoulder replacement, used to restore
  the function of the shoulder joint following
  injury or disease. Following are some guidelines
  on how to use these reconstructive surgery CPT
  codes
• Determine the type of shoulder reconstruction
  procedure being performed The codes in this
  range include various types of shoulder
  reconstruction procedures, such as rotator cuff
  repair, labral repair, and shoulder replacement.
  It is important to identify the specific
  procedure being performed in order to select the
  appropriate code.
• Identify whether the procedure is arthroscopic or
  open The codes in this range are divided based
  on whether the shoulder reconstruction procedure
  is arthroscopic or open. It is important to
  accurately document whether the procedure is
  being performed using an arthroscope or through
  an open incision in order to select the
  appropriate code.
• Choose the appropriate code based on the specific
  procedure and extent of the reconstruction Once
  the type of procedure and arthroscopic or open
  nature of the procedure have been determined, the
  appropriate CPT code can be selected from the
  range of codes available based on the specific
  procedure and extent of the reconstruction.

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Coding Guidelines for Reconstructive Surgery CPT
Codes

• Use any necessary modifiers Depending on the
  circumstances of the procedure, it may be
  necessary to use modifiers to indicate additional
  information, such as whether the procedure was
  performed as a primary or revision procedure or
  whether it involved multiple procedures or sites.
• CPT Codes 20900 20939
• CPT code range 20900 - 20939 is used for hand and
  wrist reconstruction procedures, including tendon
  repair and carpal tunnel release, used to restore
  the function of the hand and wrist following
  injury or disease. Following are some guidelines
  on how to use these reconstructive surgery CPT
  codes
• Identify the specific procedure being
  performed The codes in this range cover a range
  of hand and wrist reconstruction procedures,
  including tendon and ligament repair, fracture
  reduction, and joint reconstruction. It is
  important to accurately document the specific
  procedure being performed in order to select the
  appropriate code.
• Determine whether the procedure is performed on
  the hand or wrist The codes in this range are
  divided based on whether the procedure is being
  performed on the hand or wrist. It is important
  to accurately document the location of the
  procedure in order to select the appropriate code.

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Coding Guidelines for Reconstructive Surgery CPT
Codes

• Choose the appropriate code based on the specific
  procedure and extent of the reconstruction Once
  the type of procedure and location of the
  procedure have been determined, the appropriate
  CPT code can be selected from the range of codes
  available based on the specific procedure and
  extent of the reconstruction.
• Use any necessary modifiers Depending on the
  circumstances of the procedure, it may be
  necessary to use modifiers to indicate additional
  information, such as whether the procedure was
  performed as a primary or revision procedure or
  whether it involved multiple procedures or sites.
• We hope that above shared coding guidelines for
  reconstructive surgery CPT codes might have
  cleared some coding doubts. It is important to
  note that these are just a few examples of the
  CPT codes used in reconstructive surgery, and the
  appropriate code may vary depending on the
  specific procedure and circumstances of each
  case. It is recommended to consult with a
  qualified plastic surgery coding professional for
  further guidance.
• Medical Billers and Coders (MBC) is a
  professional billing company specializing in
  plastic surgery. With our expertise in the field
  of plastic surgery billing and coding, we provide
  comprehensive and accurate billing services to
  plastic surgery practices, ensuring timely and
  maximum reimbursement. We are knowledgeable in

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Coding Guidelines for Reconstructive Surgery CPT
Codes

• the latest CPT codes and regulations related to
  plastic surgery, and work closely with plastic
  surgeons to ensure proper documentation and
  coding of procedures.
• Our services include claims submission,
  follow-up, and denial management, as well as
  revenue cycle management and consulting. MBC
  helps plastic surgery practices to reduce billing
  errors, improve revenue, and streamline their
  billing processes. To know more about our plastic
  surgery billing and coding services, email us
  at info_at_medicalbillersandcoders.com or call us
  at 888-357-3226.
• CPT Registered Trademark of American Medical
  Association (AMA)