April 21, 2022

Question:
We are having a debate on whether to use a mastectomy code or breast reduction code for “top” female-to-male procedures. What’s your advice?

Answer:
Unfortunately, we do not have a specific CPT code(s) for these procedures as the existing codes were not written with these procedures in mind. Our advice is to consult the payor’s medical coverage policy and determine the payor’s preference for how to code for the procedure you’re performing.

*This response is based on the best information available as of 04/21/22.