Code Details & Principles for GA303
Code details & principles for
GA303
- Chapter 22 / Gender Affirmation
| Code | Description | Chapter/Sub-Chapter | Code Specific Guidance |
|---|---|---|---|
| GA303 | Chest reconstruction for gender affirmation (as sole procedure) - bilateral | 22.0.0 Gender Affirmation |
Unacceptable Combinations for GA303
| CCSD Code (unacceptable combination) | Narrative (unacceptable combination) | Date Code Added |
|---|---|---|
| B2700 | Subcutaneous mastectomy with immediate implant | Pre 2025 |
| B2710 | Radical mastectomy (including block dissection) | Pre 2025 |
| B2742 | Modified radical mastectomy (including lymph node sampling) | Pre 2025 |
| B2743 | Modified radical mastectomy excluding lymph node sampling | Pre 2025 |
| B2744 | Modified radical mastectomy (including lymph node clearance) | Pre 2025 |
| B2752 | Subcutaneous mastectomy | Pre 2025 |
| B2760 | Skin/nipple sparing mastectomy (including axillary node biopsy) - unilateral | Pre 2025 |
| B2761 | Skin/nipple sparing mastectomy (including axillary node biopsy) - bilateral | Pre 2025 |
| B2780 | Simple mastectomy (including axillary node biopsy) - unilateral | Pre 2025 |
| B2782 | Prophylactic mastectomy - unilateral | Pre 2025 |
| B2783 | Prophylactic mastectomy - bilateral | Pre 2025 |
| B2784 | Mastectomy for gynaecomastia - unilateral | Pre 2025 |
| B2785 | Mastectomy for gynaecomastia - bilateral | Pre 2025 |
| B2800 | Excision of breast lump/fibroadenoma | Pre 2025 |
| B2818 | Mastectomy and immediate reconstruction of breast using expandable prosthesis and acellular dermal matrix (ADM) - unilateral | Pre 2025 |
| B2819 | Mastectomy and immediate reconstruction of breast using expandable prosthesis and acellular dermal matrix (ADM) - bilateral | Pre 2025 |
| B2820 | Wide local excision of breast +/- local mobilisation of glandular breast tissue to fill surgical cavity | Pre 2025 |
| B2830 | Re-excision of lesion of breast if resection margins are not clear (as sole procedure) | Pre 2025 |
| B2831 | Re-excision of lesion of breast if resection margins are not clear with local mobilisation | Pre 2025 |
| B2880 | Excision biopsy of breast lesion after localisation | Pre 2025 |
| B2890 | Ultrasound guided interstitial laser ablation of breast lesion | Pre 2025 |
| B2912 | Mastectomy and immediate reconstruction of breast using latissimus dorsi | Pre 2025 |
| B2913 | Reconstruction of breast using latissimus dorsi including implantation of prosthesis (including delayed reconstruction) | Pre 2025 |
| B2914 | Mastectomy followed by immediate Deep Inferior Epigastric Flap (DIEP) reconstruction - bilateral | Pre 2025 |
| B2915 | Reconstruction of breast using extended latissimus dorsi flap (including delayed reconstruction) | Pre 2025 |
| B2916 | Mastectomy and immediate reconstruction of breast using extended latissimus dorsi flap | Pre 2025 |
| B2917 | Reconstruction of breast using fixed prosthesis and acellular dermal matrix (ADM) (including delayed reconstruction) - unilateral | Pre 2025 |
| B2918 | Mastectomy and immediate reconstruction of breast using fixed prosthesis and acellular dermal matrix (ADM) - unilateral | Pre 2025 |
| B2919 | Mastectomy and immediate reconstruction of breast using fixed prosthesis and acellular dermal matrix (ADM) - bilateral | Pre 2025 |
| B2921 | Lumpectomy and immediate partial reconstruction of breast using pedicled perforator flap (eg. Lateral Intercostal Artery Perforator (LICAP) or Thoraco-Dorsal Artery Perforator (TDAP)) | Pre 2025 |
| B2922 | Partial reconstruction of breast using pedicled perforator flap (eg. Lateral Intercostal Artery Perforator (LICAP) or Thoraco-Dorsal Artery Perforator (TDAP) including delayed reconstruction) | Pre 2025 |
| B2927 | Reconstruction of breast using fixed prosthesis and acellular dermal matrix (ADM) (including delayed reconstruction) - bilateral | Pre 2025 |
| B2981 | Local mobilisation of glandular breast tissue to fill surgical cavity | Pre 2025 |
| B2984 | Reconstruction of breast using pedicled TRAM (including delayed reconstruction) | Pre 2025 |
| B2985 | Reconstruction of breast using free TRAM (including delayed reconstruction) | Pre 2025 |
| B2986 | Reconstruction of breast using deep inferior epigastric perforator flap (DIEP) (including delayed reconstruction) - unilateral (single flap) | Pre 2025 |
| B2987 | Reconstruction of breast using transverse upper gracilis (TUG) flap (including delayed reconstruction and nipple reconstruction) | Pre 2025 |
| B2988 | Reconstruction of breast using ALT (anterolateral thigh) flap (including delayed reconstruction) | Pre 2025 |
| B2989 | Mastectomy followed by immediate Deep Inferior Epigastric Flap (DIEP) reconstruction - unilateral | Pre 2025 |
| B2990 | Reconstruction of breast using deep inferior epigastric perforator flap (DIEP) with vascularised lymph node transfer (including delayed reconstruction) - unilateral | Pre 2025 |
| B2991 | Laparoscopic mobilisation of the greater omentum for reconstruction of breast (including delayed reconstruction) | Pre 2025 |
| B2992 | Reconstruction of breast using deep inferior epigastric perforator flap (DIEP) with vascularised lymph node transfer (including delayed reconstruction) - bilateral | Pre 2025 |
| B2993 | Reconstruction of breast using stacked deep inferior epigastric perforator flap (DIEP) (including delayed reconstruction) - bilateral (2 flaps per breast) | Pre 2025 |
| B2994 | Reconstruction of breast using stacked flap (including delayed reconstruction) not elsewhere classified - unilateral (2 flaps) | Pre 2025 |
| B2995 | Reconstruction of breast using stacked flap (including delayed reconstruction) not elsewhere classified - bilateral (2 flaps per breast) | Pre 2025 |
| B2996 | Reconstruction of breast using deep inferior epigastric perforator flap (DIEP) (including delayed reconstruction) - bilateral (single flap per breast) | Pre 2025 |
| B2999 | Reconstruction of breast using stacked deep inferior epigastric perforator flap (DIEP) (including delayed reconstruction) - unilateral (2 flaps) | Pre 2025 |
| B3012 | Mastectomy and immediate reconstruction of breast using expandable prosthesis - unilateral | Pre 2025 |
| B3013 | Mastectomy and immediate reconstruction of breast using fixed prosthesis - unilateral | Pre 2025 |
| B3014 | Reconstruction of breast using expandable prosthesis (including delayed reconstruction) | Pre 2025 |
| B3015 | Reconstruction of breast using fixed prosthesis (including delayed reconstruction) | Pre 2025 |
| B3016 | Mastectomy and immediate reconstruction of breast using fat transfer | Pre 2025 |
| B3017 | Reconstruction of breast using fat transfer (including delayed reconstruction) | Pre 2025 |
| B3018 | Revision reconstruction of breast using fat transfer | Pre 2025 |
| B3020 | Fat transfer, (as sole procedure, including extraction and transfer for volume adjustment following mastectomy and reconstruction) | Pre 2025 |
| B3022 | Adjustment or revision of flap harvest site following mastectomy and breast reconstruction, including liposuction and excision of scar (as sole procedure) | Pre 2025 |
| B3032 | Removal of prosthesis from breast (including capsulectomy) | Pre 2025 |
| B3033 | Simple removal of prosthesis from breast | Pre 2025 |
| B3036 | Removal and replacement of prosthesis into the breast (including capsulectomy) - unilateral | Pre 2025 |
| B3037 | Removal and replacement of prosthesis into the breast (including capsulectomy) - bilateral | Pre 2025 |
| B3038 | Removal and reinsertion of existing prosthesis into the breast (including capsulectomy) - unilateral | Pre 2025 |
| B3039 | Removal and reinsertion of existing prosthesis into the breast (including capsulectomy) - bilateral | Pre 2025 |
| B3042 | Mastectomy and immediate reconstruction of breast using expandable prosthesis - bilateral | Pre 2025 |
| B3043 | Mastectomy and immediate reconstruction of breast using fixed prosthesis - - bilateral | Pre 2025 |
| B3100 | Reduction mammoplasty - unilateral | Pre 2025 |
| B3110 | Reduction mammoplasty - bilateral | Pre 2025 |
| B3120 | Augmentation mammoplasty - unilateral | Pre 2025 |
| B3121 | Augmentation mammoplasty - bilateral | Pre 2025 |
| B3132 | Bilateral mastopexy (following reconstruction) | Pre 2025 |
| B3140 | Therapeutic mammoplasty for breast cancer | Pre 2025 |
| B3180 | Implantation of prosthesis into breast (as sole procedure) | Pre 2025 |
| B3212 | Percutaneous suction core biopsy | Pre 2025 |
| B3220 | Core biopsy of lesion of breast - unilateral | Pre 2025 |
| B3580 | Nipple areola complex reconstruction +/- liposuction and fat transfer | Pre 2025 |
| B3810 | Reconstruction of breast using SGAP (superior gluteal artery perforator) flap (including delayed reconstruction) | Pre 2025 |
| GA300 | Subcutaneous mastectomy with related chest reconstruction for gender affirmation - unilateral | Pre 2025 |
| GA301 | Subcutaneous mastectomy with related chest reconstruction for gender affirmation - bilateral | Pre 2025 |
| GA302 | Chest reconstruction for gender affirmation (as sole procedure) - unilateral | Pre 2025 |
| S1500 | Biopsy of skin or subcutaneous tissue | Pre 2025 |
| S1700 | Distant flap - delay/division/inset | Pre 2025 |
| S1740 | Large myocutaneous (muscular/cutaneous) flap (9cm2 or more) (including closure of secondary defect) | Pre 2025 |
| S1750 | Large muscle flap (9cm2 or more) (including skin graft and closure of secondary defect) | Pre 2025 |
| S1900 | Distant pedicle flap - elevation including transfer (including closure/grafting to secondary defect) | Pre 2025 |
| S2000 | Large island skin flap (9cm2 or more) (e.g. radial forearm) (including closure of secondary defect) | Pre 2025 |
| S2002 | Small island flap (less than 9cm2) | Pre 2025 |
| S2220 | Neurovascular island flap | Pre 2025 |
| S2500 | Local flap - less than 9cm2 | Pre 2025 |
| S2502 | Local flap - 9cm2 or more (excluding graft/flap to secondary defect) | Pre 2025 |
| S2503 | Local flap - 9cm2 or more (including graft/flap to secondary defect) | Pre 2025 |
| S3500 | Split autograft of skin, trunk and limbs - up to 25cm2 | Pre 2025 |
| S3530 | Split autograft of skin, trunk and limbs - over 25cm2 and up to 5% of body surface area | Pre 2025 |
| S3532 | Split autograft of skin, trunk and limbs - each additional 5% of body surface area | Pre 2025 |
| S3622 | Full thickness graft, trunk and limbs - up to 9cm2 in area | Pre 2025 |
| S3623 | Full thickness graft, trunk and limbs - each additional 25cm2 in area | Pre 2025 |
| S4230 | Secondary suture of skin | Pre 2025 |
| S4950 | Fat transfer, including extraction and volume adjustment, of scar defect following trauma (excluding breast) | Pre 2025 |
| T7602 | Microvascular free tissue transfer (when added to other codes) (including closure of secondary defect) | Pre 2025 |
| T7603 | Microvascular free tissue transfer (as sole procedure including closure of secondary defect) | Pre 2025 |
| T7620 | Free functioning muscle transfer (as sole procedure) (including closure of secondary defect) | Pre 2025 |
| T8620 | Sampling of axillary lymph nodes | Pre 2025 |
| T8700 | Excision biopsy of lymph node for diagnosis (cervical, inguinal, axillary) | Pre 2025 |
| W3180 | Free composite (i.e. including bone) vascularised grafts | Pre 2025 |
Coding Principles
These coding principles set out how the authors intend that the codes and narratives within the CCSD Schedule are interpreted and used. The outputs are available to be used by all individual insurers and providers including CCSD and non-CCSD members. Please note that:
- The CCSD Group does not discuss nor determine classifcations, reimbursement or fees - all insurers will have their own view on these matters
- The inclusion of a procedure code and/or its associated coding principles in the CCSD Schedule does not necessarily mean that it is endorsed by all members of the CCSD Group and codes may or may not be included in individual insurers' own Schedules or covered
- The coding principles are non-exhaustive guidelines only - each individual insurer may choose whether or not to adopt an individual combination of codes in practice and you will need to contact the insurer for further information