2025 CPT code 19342
(Active) Effective Date: N/A Surgical Procedures on the Integumentary System - Integumentary System Surgery Feed
Delayed insertion or replacement of a breast implant following a mastectomy or in reconstruction.
Modifiers may be applicable. For example, modifier 50 is used for bilateral procedures.
Medical necessity for this procedure should be established based on the patient's individual circumstances and the goals of reconstruction. This may include restoring body image, improving symmetry, and addressing psychological impact of mastectomy.
The physician prepares the patient and administers anesthesia. An incision is made, typically over the previous mastectomy scar. A pocket is created for the implant, and the surrounding tissues and skin are adjusted. The implant is inserted into the pocket, and the incision is closed with sutures.
In simple words: This procedure involves inserting or replacing a breast implant after a mastectomy, when the breast tissue has been removed.It can be done as part of a breast reconstruction surgery.The procedure may involve placing a new implant or replacing an existing one. If an existing implant needs to be replaced, its removal is included in this procedure.
This code describes a procedure where a breast implant is inserted or replaced at a later date from the original mastectomy. It includes placement of a new implant, replacement of an existing implant within the mastectomy defect or reconstructed breast, and removal of an intact breast implant for replacement.
Example 1: A patient who underwent a mastectomy six months prior returns for delayed breast reconstruction with an implant., A patient with a previous implant-based reconstruction experiences a capsular contracture and requires implant replacement., A patient decides to replace an existing breast implant with a different size or type.
Documentation should include details of the mastectomy, type and size of the implant, operative report, and any complications.
- Specialties:Plastic Surgery, Reconstructive Surgery
- Place of Service:Ambulatory Surgical Center, Hospital - Inpatient, Hospital - Outpatient