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CODING & BILLING
Autologous fat transfer
Although most breast reconstructions are performed with implants,
some patients are opting for autologous fat transfer (AFT) procedures. In these procedures, the patient wears an external tissue
expander such as the Brava device for about a month before the procedure. During the procedure, liposuction is performed to harvest fat
for the breast reconstruction. The fat is centrifuged and placed into
syringes, which are used to transfer the fat into the breast.
When AFT is the sole method of reconstructing the breast, report
code 19366 [Breast reconstruction with other technique], according to
the December 2011 CPT Assistant. The liposuction procedure to
harvest the fat is not separately reported. Under both the ASC and
OPPS payment systems, a multiple procedure reduction applies,
which means the procedure on the contralateral breast is reduced
for bilateral procedures performed on the same date of service.
There are a few things to consider with this procedure. Not long
ago, placing fat grafts into the breast was not considered safe. Fat
necrosis was common, and that complication could interfere with
subsequent mammograms. With current techniques, including low
suction pressure for the harvest of fat, centrifuging of the fat to
remove fluids and injection of smaller fat particles into the breast,
survival of the fat cells has improved significantly. However, this
careful attention to
the harvesting and
Medicare Reimbursement for
processing of the
Biologic Breast Implants
fat increases operBiologic Implant HCPCS code ASC
OPPS APC
ating times.
Alloderm
Q4116
$31.69* $32.21* 1270
Surgeries can averDermagraft
Q4106
$42.55* $42.57* 1245
age more than 1
* Per square centimeter
3 4
O U T PAT I E N T S U R G E R Y M A G A Z I N E O N L I N E | S E P T E M B E R 2013
