2025 CPT code 19368
(Active) Effective Date: N/A Surgery - Integumentary System Feed
Breast reconstruction with single-pedicled transverse rectus abdominis myocutaneous (TRAM) flap, requiring separate microvascular anastomosis (supercharging).
Modifiers such as 22 (Increased Procedural Services), 50 (Bilateral Procedure), 59 (Distinct Procedural Service), etc., may be applicable depending on the specific circumstances of the procedure.
Medical necessity is established based on the underlying reason for the breast reconstruction, such as cancer treatment, congenital anomaly, or complications from previous reconstruction. The supercharging component is justified when enhanced blood supply to the flap is necessary for its survival or optimal aesthetic outcomes.
The surgeon performs the entire procedure, from preparing the recipient site to harvesting the TRAM flap, performing the microvascular anastomosis, and closing the surgical sites.This includes careful monitoring of the flap post-operatively to ensure its viability.
In simple words: The surgeon reconstructs the breast by transferring tissue from the lower belly to the chest area.Tiny blood vessels are reconnected under a microscope to improve blood flow to the transferred tissue, helping it survive and look its best. This is often done after a mastectomy or to correct a breast defect.
This procedure involves the reconstruction of the breast using a single-pedicled TRAM flap, where skin, fat, and muscle from the lower abdomen are transposed to the chest. A separate microvascular anastomosis (supercharging) is performed to enhance blood supply to the flap, ensuring its viability and improving the aesthetic outcome of the reconstruction.
Example 1: A patient undergoes a mastectomy due to breast cancer and chooses a TRAM flap reconstruction with supercharging for optimal aesthetic results., A patient with a congenital breast defect undergoes reconstructive surgery using a single-pedicled TRAM flap with supercharging to create a natural-looking breast mound., A patient who previously had a TRAM flap reconstruction experiences complications with flap viability and undergoes a revision procedure including supercharging to improve blood flow and prevent flap necrosis.
Documentation should include the medical necessity for the procedure (e.g., mastectomy, congenital defect, prior reconstruction complications), details of the TRAM flap harvesting and inset, the type of microvascular anastomosis performed, and any intraoperative or postoperative complications.
- Specialties:Plastic Surgery, Reconstructive Surgery
- Place of Service:Ambulatory Surgical Center, Hospital Inpatient, Hospital Outpatient