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The procedure described by CPT® Code 19355 involves the correction of inverted nipples, a condition where the nipple is retracted into the breast rather than protruding outward. This condition can lead to breast asymmetry and may pose challenges for breastfeeding. Nipple inversion is typically categorized based on several factors, including the ease with which the nipple can be protracted, the extent of fibrosis present, and any damage to the milk ducts. For cases of mild to moderate nipple inversion, minimally invasive surgical techniques are often employed. These techniques include nipple piercing and the placement of sutures around the areola, both of which aim to preserve the milk ducts, thereby allowing for the possibility of breastfeeding post-procedure. In the nipple piercing technique, a metal bar is inserted through the areola, positioned directly behind the nipple, and secured in place. This piercing serves to prevent the nipple from reverting back into the breast tissue, and it is typically retained for a specified duration to facilitate the formation of scar tissue. Once the piercing is removed, the expectation is that the nipple will remain in a protracted position. Alternatively, the suture technique involves protracting the nipple and placing absorbable sutures around the areola, which are then tightened to reshape both the areola and the nipple. As the sutures dissolve, scar tissue forms around them, helping to maintain the protracted position of the nipple. In more severe cases of nipple inversion, a more complex surgical approach may be necessary. This may involve the potential sacrifice of milk ducts and could result in a loss of skin sensation. The procedure may include placing a suture through the nipple to ensure adequate protraction, making a small incision at the base of the nipple, and using sharp dissection to cut through the milk ducts and fibrous tissue. Following this, absorbable sutures are placed behind the nipple to keep it protracted, and the incision in the areola is subsequently closed. Overall, the goal of the procedure is to correct the inversion while considering the preservation of breastfeeding capabilities and minimizing complications.
© Copyright 2025 Coding Ahead. All rights reserved.
The procedure for the correction of inverted nipples, as described by CPT® Code 19355, is indicated for the following conditions:
The procedure for correcting inverted nipples involves several key steps, which are detailed as follows:
Post-procedure care for patients undergoing correction of inverted nipples includes monitoring for any complications and ensuring proper healing. Patients are typically advised on how to care for the surgical site, including keeping it clean and dry. Follow-up appointments may be scheduled to assess the healing process and the success of the procedure in maintaining nipple protraction. Patients should also be informed about the potential for changes in sensation and the importance of reporting any unusual symptoms during recovery.
| Short Descr | CORRECT INVERTED NIPPLE(S) | Medium Descr | CORRECTION INVERTED NIPPLES | Long Descr | Correction of inverted nipples | Status Code | Active Code | Global Days | 090 - Major Surgery | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 2 - Standard payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 1 - 150% payment adjustment for bilateral procedures applies. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 0 - Payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Hospital Part B services paid through a comprehensive APC | ASC Payment Indicator | Surgical procedure on ASC list in CY 2007; payment based on OPPS relative payment weight. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P5E - Ambulatory procedures - other | MUE | 1 | CCS Clinical Classification | 175 - Other OR therapeutic procedures on skin and breast |
| 22 | Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service. | 50 | Bilateral procedure: unless otherwise identified in the listings, bilateral procedures that are performed at the same session, should be identified by adding modifier 50 to the appropriate 5 digit code. note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 78 | Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.) | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | GC | This service has been performed in part by a resident under the direction of a teaching physician | GZ | Item or service expected to be denied as not reasonable and necessary | LT | Left side (used to identify procedures performed on the left side of the body) | RT | Right side (used to identify procedures performed on the right side of the body) | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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| Pre-1990 | Added | Code added. |
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