Code Details & Principles for B3043
Code details & principles for
B3043
- Chapter 7 / Mastectomy (excluding Implant/Reconstruction)
| Code | Description | Chapter/Sub-Chapter | Code Specific Guidance |
|---|---|---|---|
| B3043 | Mastectomy and immediate reconstruction of breast using fixed prosthesis - - bilateral | 7.2.0 Mastectomy (excluding Implant/Reconstruction) |
Unacceptable Combinations for B3043
| CCSD Code (unacceptable combination) | Narrative (unacceptable combination) | Date Added |
|---|---|---|
| B2700 | Subcutaneous mastectomy with immediate implant | 2010-01-20 |
| B2780 | Simple mastectomy (including axillary node biopsy) - unilateral | 2013-10-04 |
| B2782 | Prophylactic mastectomy - unilateral | 2010-01-20 |
| B2783 | Prophylactic mastectomy - bilateral | 2010-01-20 |
| B2784 | Mastectomy for gynaecomastia - unilateral | 2010-01-20 |
| B2785 | Mastectomy for gynaecomastia - bilateral | 2010-01-20 |
| B2912 | Mastectomy and immediate reconstruction of breast using latissimus dorsi | 2010-01-20 |
| B2913 | Reconstruction of breast using latissimus dorsi including implantation of prosthesis (including delayed reconstruction) | 2013-06-03 |
| B2914 | Mastectomy followed by immediate Deep Inferior Epigastric Flap (DIEP) reconstruction - bilateral | 2016-02-04 |
| B2915 | Reconstruction of breast using extended latissimus dorsi flap (including delayed reconstruction) | 2011-06-03 |
| B2916 | Mastectomy and immediate reconstruction of breast using extended latissimus dorsi flap | 2011-01-20 |
| B2917 | Reconstruction of breast using fixed prosthesis and acellular dermal matrix (ADM) (including delayed reconstruction) - unilateral | 2015-11-30 |
| B2918 | Mastectomy and immediate reconstruction of breast using fixed prosthesis and acellular dermal matrix (ADM) - unilateral | 2015-11-30 |
| B2919 | Mastectomy and immediate reconstruction of breast using fixed prosthesis and acellular dermal matrix (ADM) - bilateral | 2017-02-01 |
| B2927 | Reconstruction of breast using fixed prosthesis and acellular dermal matrix (ADM) (including delayed reconstruction) - bilateral | 2021-04-22 |
| B2984 | Reconstruction of breast using pedicled TRAM (including delayed reconstruction) | 2010-01-20 |
| B2985 | Reconstruction of breast using free TRAM (including delayed reconstruction) | 2010-01-20 |
| B2987 | Reconstruction of breast using transverse upper gracilis (TUG) flap (including delayed reconstruction and nipple reconstruction) | 2010-01-20 |
| B2988 | Reconstruction of breast using ALT (anterolateral thigh) flap (including delayed reconstruction) | 2011-11-15 |
| B2992 | Reconstruction of breast using deep inferior epigastric perforator flap (DIEP) with vascularised lymph node transfer (including delayed reconstruction) - bilateral | 2015-06-04 |
| B2993 | Reconstruction of breast using stacked deep inferior epigastric perforator flap (DIEP) (including delayed reconstruction) - bilateral (2 flaps per breast) | 2017-12-11 |
| B2996 | Reconstruction of breast using deep inferior epigastric perforator flap (DIEP) (including delayed reconstruction) - bilateral (single flap per breast) | 2015-05-06 |
| B3012 | Mastectomy and immediate reconstruction of breast using expandable prosthesis - unilateral | 2010-01-20 |
| B3013 | Mastectomy and immediate reconstruction of breast using fixed prosthesis - unilateral | 2010-01-20 |
| B3014 | Reconstruction of breast using expandable prosthesis (including delayed reconstruction) | 2010-01-20 |
| B3015 | Reconstruction of breast using fixed prosthesis (including delayed reconstruction) | 2010-01-20 |
| B3036 | Removal and replacement of prosthesis into the breast (including capsulectomy) - unilateral | 2020-08-06 |
| B3037 | Removal and replacement of prosthesis into the breast (including capsulectomy) - bilateral | 2020-08-06 |
| B3038 | Removal and reinsertion of existing prosthesis into the breast (including capsulectomy) - unilateral | 2020-08-07 |
| B3039 | Removal and reinsertion of existing prosthesis into the breast (including capsulectomy) - bilateral | 2020-08-07 |
| B3042 | Mastectomy and immediate reconstruction of breast using expandable prosthesis - bilateral | 2019-05-31 |
| B3810 | Reconstruction of breast using SGAP (superior gluteal artery perforator) flap (including delayed reconstruction) | 2011-11-04 |
| GA300 | Subcutaneous mastectomy with related chest reconstruction for gender affirmation - unilateral | 2024-10-08 |
| GA301 | Subcutaneous mastectomy with related chest reconstruction for gender affirmation - bilateral | 2024-10-08 |
| GA303 | Chest reconstruction for gender affirmation (as sole procedure) - bilateral | 2024-10-08 |
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