March 10, 2022

Question:
A patient has a partial mastectomy by a general surgeon. After the surgery, a plastic surgeon comes in to close due to possible reconstruction. The plastic surgeon ends up only doing a layered closure. A layered closure is inclusive the in the partial mastectomy (19301) but is the plastic surgeon still able to get credit for the layered closure (12034) because she is a different specialty?

Answer:
In our experience, no, the plastic surgeon would not be reimbursed for a simple, intermediate or complex repair code in this situation. Sorry. Good question though!

*This response is based on the best information available as of 02/24/22.