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 Added |
|---|---|---|
| B2700 | Subcutaneous mastectomy with immediate implant | 2010-01-20 |
| B2710 | Radical mastectomy (including block dissection) | 2011-11-04 |
| B2742 | Modified radical mastectomy (including lymph node sampling) | 2011-11-04 |
| B2743 | Modified radical mastectomy excluding lymph node sampling | 2010-01-20 |
| B2744 | Modified radical mastectomy (including lymph node clearance) | 2011-11-04 |
| B2752 | Subcutaneous mastectomy | 2010-01-20 |
| B2760 | Skin/nipple sparing mastectomy (including axillary node biopsy) - unilateral | 2010-01-20 |
| B2761 | Skin/nipple sparing mastectomy (including axillary node biopsy) - bilateral | 2021-04-22 |
| 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 |
| B2800 | Excision of breast lump/fibroadenoma | 2012-12-09 |
| B2818 | Mastectomy and immediate reconstruction of breast using expandable prosthesis and acellular dermal matrix (ADM) - unilateral | 2022-04-14 |
| B2819 | Mastectomy and immediate reconstruction of breast using expandable prosthesis and acellular dermal matrix (ADM) - bilateral | 2022-04-14 |
| B2820 | Wide local excision of breast +/- local mobilisation of glandular breast tissue to fill surgical cavity | 2014-06-18 |
| B2830 | Re-excision of lesion of breast if resection margins are not clear (as sole procedure) | 2010-01-20 |
| B2831 | Re-excision of lesion of breast if resection margins are not clear with local mobilisation | 2013-08-20 |
| B2880 | Excision biopsy of breast lesion after localisation | 2010-01-20 |
| B2890 | Ultrasound guided interstitial laser ablation of breast lesion | 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 |
| B2921 | Lumpectomy and immediate partial reconstruction of breast using pedicled perforator flap (eg. Lateral Intercostal Artery Perforator (LICAP) or Thoraco-Dorsal Artery Perforator (TDAP)) | 2014-04-03 |
| B2922 | Partial reconstruction of breast using pedicled perforator flap (eg. Lateral Intercostal Artery Perforator (LICAP) or Thoraco-Dorsal Artery Perforator (TDAP) including delayed reconstruction) | 2014-04-03 |
| B2927 | Reconstruction of breast using fixed prosthesis and acellular dermal matrix (ADM) (including delayed reconstruction) - bilateral | 2021-04-22 |
| B2981 | Local mobilisation of glandular breast tissue to fill surgical cavity | 2013-05-08 |
| 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 |
| B2986 | Reconstruction of breast using deep inferior epigastric perforator flap (DIEP) (including delayed reconstruction) - unilateral (single flap) | 2011-03-11 |
| 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 |
| B2989 | Mastectomy followed by immediate Deep Inferior Epigastric Flap (DIEP) reconstruction - unilateral | 2010-12-09 |
| B2990 | Reconstruction of breast using deep inferior epigastric perforator flap (DIEP) with vascularised lymph node transfer (including delayed reconstruction) - unilateral | 2014-11-06 |
| B2991 | Laparoscopic mobilisation of the greater omentum for reconstruction of breast (including delayed reconstruction) | 2011-03-11 |
| 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 |
| B2994 | Reconstruction of breast using stacked flap (including delayed reconstruction) not elsewhere classified - unilateral (2 flaps) | 2022-04-14 |
| B2995 | Reconstruction of breast using stacked flap (including delayed reconstruction) not elsewhere classified - bilateral (2 flaps per breast) | 2022-04-14 |
| B2996 | Reconstruction of breast using deep inferior epigastric perforator flap (DIEP) (including delayed reconstruction) - bilateral (single flap per breast) | 2015-05-06 |
| B2999 | Reconstruction of breast using stacked deep inferior epigastric perforator flap (DIEP) (including delayed reconstruction) - unilateral (2 flaps) | 2017-12-11 |
| 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 |
| B3016 | Mastectomy and immediate reconstruction of breast using fat transfer | 2010-01-20 |
| B3017 | Reconstruction of breast using fat transfer (including delayed reconstruction) | 2010-01-20 |
| B3018 | Revision reconstruction of breast using fat transfer | 2010-01-20 |
| B3020 | Fat transfer, (as sole procedure, including extraction and transfer for volume adjustment following mastectomy and reconstruction) | 2011-11-04 |
| B3022 | Adjustment or revision of flap harvest site following mastectomy and breast reconstruction, including liposuction and excision of scar (as sole procedure) | 2014-11-06 |
| B3032 | Removal of prosthesis from breast (including capsulectomy) | 2011-11-04 |
| B3033 | Simple removal of prosthesis from breast | 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 |
| B3043 | Mastectomy and immediate reconstruction of breast using fixed prosthesis - - bilateral | 2019-05-31 |
| B3100 | Reduction mammoplasty - unilateral | 2010-01-20 |
| B3110 | Reduction mammoplasty - bilateral | 2010-01-20 |
| B3120 | Augmentation mammoplasty - unilateral | 2010-01-20 |
| B3121 | Augmentation mammoplasty - bilateral | 2010-01-20 |
| B3132 | Bilateral mastopexy (following reconstruction) | 2017-12-11 |
| B3140 | Therapeutic mammoplasty for breast cancer | 2012-12-09 |
| B3180 | Implantation of prosthesis into breast (as sole procedure) | 2011-03-11 |
| B3212 | Percutaneous suction core biopsy | 2010-01-20 |
| B3220 | Core biopsy of lesion of breast - unilateral | 2010-01-20 |
| B3580 | Nipple areola complex reconstruction +/- liposuction and fat transfer | 2014-06-19 |
| 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 |
| GA302 | Chest reconstruction for gender affirmation (as sole procedure) - unilateral | 2024-10-08 |
| S1500 | Biopsy of skin or subcutaneous tissue | 2011-03-11 |
| S1700 | Distant flap - delay/division/inset | 2010-01-20 |
| S1740 | Large myocutaneous (muscular/cutaneous) flap (9cm2 or more) (including closure of secondary defect) | 2011-11-04 |
| S1750 | Large muscle flap (9cm2 or more) (including skin graft and closure of secondary defect) | 2011-11-04 |
| S1900 | Distant pedicle flap - elevation including transfer (including closure/grafting to secondary defect) | 2010-01-20 |
| S2000 | Large island skin flap (9cm2 or more) (e.g. radial forearm) (including closure of secondary defect) | 2011-11-04 |
| S2002 | Small island flap (less than 9cm2) | 2010-01-20 |
| S2220 | Neurovascular island flap | 2010-01-20 |
| S2500 | Local flap - less than 9cm2 | 2013-03-03 |
| S2502 | Local flap - 9cm2 or more (excluding graft/flap to secondary defect) | 2010-01-20 |
| S2503 | Local flap - 9cm2 or more (including graft/flap to secondary defect) | 2010-01-20 |
| S3500 | Split autograft of skin, trunk and limbs - up to 25cm2 | 2011-03-11 |
| S3530 | Split autograft of skin, trunk and limbs - over 25cm2 and up to 5% of body surface area | 2011-03-11 |
| S3532 | Split autograft of skin, trunk and limbs - each additional 5% of body surface area | 2010-01-20 |
| S3622 | Full thickness graft, trunk and limbs - up to 9cm2 in area | 2011-03-11 |
| S3623 | Full thickness graft, trunk and limbs - each additional 25cm2 in area | 2010-01-20 |
| S4230 | Secondary suture of skin | 2010-01-20 |
| S4950 | Fat transfer, including extraction and volume adjustment, of scar defect following trauma (excluding breast) | 2013-10-04 |
| T7602 | Microvascular free tissue transfer (when added to other codes) (including closure of secondary defect) | 2011-11-04 |
| T7603 | Microvascular free tissue transfer (as sole procedure including closure of secondary defect) | 2010-01-20 |
| T7620 | Free functioning muscle transfer (as sole procedure) (including closure of secondary defect) | 2011-11-04 |
| T8620 | Sampling of axillary lymph nodes | 2013-06-04 |
| T8700 | Excision biopsy of lymph node for diagnosis (cervical, inguinal, axillary) | 2010-01-20 |
| W3180 | Free composite (i.e. including bone) vascularised grafts | 2010-01-20 |
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