Code Details & Principles for B2919
Code details & principles for
B2919
- Chapter 7 / Reconstruction
| Code | Description | Chapter/Sub-Chapter | Code Specific Guidance |
|---|---|---|---|
| B2919 | Mastectomy and immediate reconstruction of breast using fixed prosthesis and acellular dermal matrix (ADM) - bilateral | 7.3.0 Reconstruction |
Unacceptable Combinations for B2919
| CCSD Code (unacceptable combination) | Narrative (unacceptable combination) | Date Code Added |
|---|---|---|
| B2760 | Skin/nipple sparing mastectomy (including axillary node biopsy) - unilateral | Pre 2025 |
| B2761 | Skin/nipple sparing mastectomy (including axillary node biopsy) - bilateral | Pre 2025 |
| B2819 | Mastectomy and immediate reconstruction of breast using expandable prosthesis and acellular dermal matrix (ADM) - bilateral | Pre 2025 |
| B2914 | Mastectomy followed by immediate Deep Inferior Epigastric Flap (DIEP) reconstruction - bilateral | Pre 2025 |
| B2986 | Reconstruction of breast using deep inferior epigastric perforator flap (DIEP) (including delayed reconstruction) - unilateral (single flap) | Pre 2025 |
| B2989 | Mastectomy followed by immediate Deep Inferior Epigastric Flap (DIEP) reconstruction - unilateral | Pre 2025 |
| B2993 | Reconstruction of breast using stacked deep inferior epigastric perforator flap (DIEP) (including delayed reconstruction) - bilateral (2 flaps per breast) | 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 |
| 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 |
| GA302 | Chest reconstruction for gender affirmation (as sole procedure) - unilateral | Pre 2025 |
| GA303 | Chest reconstruction for gender affirmation (as sole procedure) - bilateral | 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