Guidelines

What is the CPT code for bilateral labiaplasty?

What is the CPT code for bilateral labiaplasty?

What is the Labiaplasty CPT Code? CPT Code 56620 is the best code to report for the Labiaplasty procedure. In 2018 the national medicare payment to physician for performing this procedure is $538.55.

Does Medicare cover labiaplasty?

There is no Medicare coverage determination addressing labiaplasty. 15839 Excision, excessive skin and subcutaneous tissue (includes lipectomy); other area 58899 Unlisted procedure, female genital system (non-obstetrical) There is no specific CPT code for labiaplasty.

Is labiaplasty a simple procedure?

It is important to educate the patient that labiaplasty is generally an elective procedure done primarily for cosmetic reasons. The procedure is relatively simple but also associated with a number of serious complications.

When is a labiaplasty medically necessary?

Only occasionally, according to ACOG, is labiaplasty medically necessary, such as with labia hypertrophy (overgrowth) caused by excess testosterone, congenital conditions, or chronic irritation.

What is the CPT code for labial reduction?

Labiaplasty must be reported using the Current Procedural Terminology (CPT) code 58999.

What is procedure code 15839?

CPT 15839 (Excision, excessive skin and subcutaneous tissue (includes lipectomy); other area) would never be separately reported for only excision of excess skin during a breast reconstruction or revision procedure. This service is included in whatever primary procedure code you’re billing. information, click here.

How much is a labial reduction?

How much does labiaplasty cost? While the price of the procedure varies from patient to patient, you should expect to pay between $4,500 – $6,000 for labiaplasty.

How can I get my insurance to pay for labiaplasty?

Unfortunately, in most cases insurance will not cover or approve labiaplasty surgery. Insurance companies look at a procedure and determine if it is “medically necessary”. They do this in a couple of different ways. One way is to define surgery as reconstructive or cosmetic.

Is labiaplasty covered by insurance?

Cosmetic labiaplasty may be done in-office and is not covered by insurance. When a labiaplasty is considered medically necessary, this can be billed through one’s insurance and performed as an outpatient procedure at a surgery center.

Is CPT code 19318 a bilateral code?

For example, in bilateral coding a breast reduction (19318) or a TRAM flap (19367), do I put the codes on one line or 2? Example: 19318-50 or 19318 and 19318-50. Answer: The charge entry format depends on the payer preference.

Does labiaplasty increase sensitivity?

Because of this, you needn’t worry about a decrease in sexual sensation after a labiaplasty – in fact, you won’t notice much of an increase, either. In short, the amount of sensation that you feel after a labiaplasty will remain the same as it was before the procedure.

What is the CPT code for labiaplasty?

Labiaplasty, or labia reduction (Current Procedural Terminology [CPT] codes 15839 or 56620), is a surgical procedure that removes tissue from the labia, and/or reshapes the labia. The procedure may be performed for

When to use code 624.3 for labia reduction?

Diagnosis most often used by my physicians is 624.3 unless the physician has specified it as a congenital problem, then code 752.49. However, if the labia appears to be normal medically without “excess” growth, I would agree with V50.1 if the patient is doing it for cosmetic reasons only.

Is there cross coding for labia minora removal?

However 56620 includes removal of clitoris and part of labia majora as well as labia minora. And the cross-coding for Dx doesn’t include V50.1. How about 15839 – RExcision excessive skin and subcutaneous tissue, other area?

How to find out if a CPT code is bilateral?

For instance, you can look up what a certain procedure’s bilateral indicator is. For the state of Oklahoma, our current MAC is Novitas Solutions. Once on the site, you will access the physician fee schedule and enter your code.