How To Use cpt 11970

cpt 11970 describes the replacement of a tissue expander with a permanent implant. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples of cpt 11970.

1. What is cpt 11970?

cpt 11970 is a code used to describe the procedure of replacing a tissue expander with a permanent implant. This procedure is performed by a healthcare provider when a previously inserted tissue expander needs to be replaced with a permanent implant. The provider makes an incision at the site of the tissue expander, removes it, and inserts a permanent implant in its place.

2. Official Description

The official description of cpt 11970 is: ‘Replacement of tissue expander with permanent implant.’

3. Procedure

1. The patient is appropriately prepped and anesthetized.
2. The healthcare provider makes an incision at the site of the previously inserted tissue expander.
3. The provider removes the tissue expander.
4. A permanent implant, which can be an artificial implant or tissue graft, is inserted into the area.
5. The provider may use screws or wires to hold the implant in place.
6. The incision is closed with sutures.

4. Qualifying circumstances

cpt 11970 is performed when a tissue expander needs to be replaced with a permanent implant. This procedure is typically done for patients who have undergone previous tissue expansion and are now ready for the placement of a permanent implant. The patient must meet the criteria for the procedure, and the healthcare provider must determine that the replacement is necessary.

5. When to use cpt code 11970

cpt 11970 should be used when a tissue expander needs to be replaced with a permanent implant. It is important to ensure that the procedure meets the specific criteria for this code. If the procedure involves the removal of a tissue expander without the placement of an implant, a different code should be used. Similarly, if the procedure involves the insertion of a tissue expander for a different area of the body, a different code should be used.

6. Documentation requirements

To support a claim for cpt 11970, the healthcare provider must document the following information:

• Indication for the replacement of the tissue expander with a permanent implant
• Details of the procedure, including the incision site and the type of permanent implant used
• Date of the procedure
• Any additional procedures performed during the same session
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for cpt 11970, ensure that the procedure meets the specific criteria for this code. It is important to accurately report the replacement of the tissue expander with a permanent implant. There are no specific guidelines regarding reporting cpt 11970 with other codes, but it is important to follow the appropriate coding guidelines and ensure accurate documentation.

8. Historical information

cpt 11970 was added to the Current Procedural Terminology system on January 1, 1990. The code has not undergone any updates or changes since its addition.

9. Similar codes to cpt 11970

There are no similar codes to cpt 11970 within the range of procedures on the integumentary system.

9. Examples

1. A patient who previously had a tissue expander inserted for breast reconstruction undergoes the replacement of the tissue expander with a permanent breast implant.
2. A patient who had a tissue expander inserted for facial reconstruction due to trauma undergoes the replacement of the tissue expander with a permanent facial implant.
3. A patient who had a tissue expander inserted for abdominal wall reconstruction undergoes the replacement of the tissue expander with a permanent abdominal implant.
4. A patient who had a tissue expander inserted for scalp reconstruction due to a tumor undergoes the replacement of the tissue expander with a permanent scalp implant.
5. A patient who had a tissue expander inserted for chest wall reconstruction due to a defect undergoes the replacement of the tissue expander with a permanent chest implant.
6. A patient who had a tissue expander inserted for buttock augmentation undergoes the replacement of the tissue expander with a permanent buttock implant.
7. A patient who had a tissue expander inserted for penile reconstruction undergoes the replacement of the tissue expander with a permanent penile implant.
8. A patient who had a tissue expander inserted for ear reconstruction due to a congenital anomaly undergoes the replacement of the tissue expander with a permanent ear implant.
9. A patient who had a tissue expander inserted for hand reconstruction due to a traumatic injury undergoes the replacement of the tissue expander with a permanent hand implant.
10. A patient who had a tissue expander inserted for lower limb reconstruction due to a tumor undergoes the replacement of the tissue expander with a permanent lower limb implant.