2025 HCPCS code S2066
Reconstruction of a single breast with gluteal artery perforator (GAP) flap, including harvesting, microvascular transfer, donor site closure, and shaping.
Modifiers may be applicable to further specify the circumstances of the procedure (e.g., laterality, increased procedural services).
Medical necessity for S2066 is determined by the patient's condition and the reason for breast reconstruction. It may be deemed medically necessary following mastectomy, for congenital deformities, or to correct failed implant reconstructions, aiming to restore form and function.
The surgeon performs the entire procedure, from prepping the patient and harvesting the GAP flap to transferring and shaping the flap, closing incisions, and ensuring proper blood supply to the reconstructed breast.
In simple words: This procedure reconstructs one breast using tissue and blood vessels from the buttock. The surgeon carefully moves the tissue and reattaches the blood vessels to create a new breast shape.
The provider reconstructs a single breast using a gluteal artery perforator (GAP) flap. This involves harvesting the GAP flap from the buttock, transferring it to the mastectomy site using microvascular techniques to connect the blood supply, closing the donor site, and shaping the flap into a breast.
Example 1: A patient who underwent a unilateral mastectomy due to breast cancer now desires breast reconstruction using a GAP flap., A patient with a congenital breast deformity undergoes a single breast reconstruction using a GAP flap., A patient who previously had breast reconstruction with an implant now chooses to have it revised using a GAP flap for improved aesthetic outcomes.
Documentation should include the medical necessity for breast reconstruction, the type of mastectomy performed, details of the GAP flap harvesting and transfer, operative report, and any complications encountered.
** S2066 offers a more precise way to describe this specific type of breast reconstruction compared to previously available codes, aiding in accurate tracking and reimbursement. However, it is important to confirm coverage with the specific payer, as this is a temporary HCPCS code. This response is valid as of today, December 10, 2024, and may be subject to change with updates to coding guidelines.
- Payment Status: Not payable by Medicare
- Specialties:Plastic Surgery, Reconstructive Surgery
- Place of Service:Ambulatory Surgical Center, Hospital, Inpatient Hospital