Prior Auth Required

19396 - Preparation, Moulage, Custom Breast Implant

This procedure appears on the selected insurer prior authorization source.

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Procedure / ServicePreparation, Moulage, Custom Breast Implant
Procedure / Service Description

Placement of radiotherapy after loading brachytherapy catheters (multiple tube and button - inset of flaps in autologous reconstruction or significant capsular revision combined with soft 19380 tissue excision in implant-based reconstruction) 19396 Preparation, Moulage, Custom Breast Implant Placement of needles or catheters into muscle and/or soft tissue for subsequent interstitial 20555 radioelement application (at the time of or subsequent to the procedure)

Likely documents
  • Confirm benefit details
  • Submit clinical notes if requested by the plan
Next actions
  • Confirm the current plan policy before submission.
  • Use the insurer authorization workflow for this listed code.