CPT® Code 19364

The CPT® Code 19364 refers to a surgical procedure known as breast reconstruction using a free flap technique. This method involves the transfer of a free flap, which is a section of skin, fat, and sometimes muscle, from a donor site on the patient's body to reconstruct the breast after a mastectomy. The donor sites are typically located in the lower abdomen, but can also include the buttocks or thigh, depending on the patient's anatomy and the specific requirements of the reconstruction. The procedure is designed to restore the breast's appearance and shape, providing a more natural look and feel. In this technique, the blood vessels of the harvested flap are meticulously preserved and reattached to the recipient site on the chest wall, ensuring adequate blood supply to the newly formed breast. Various types of free flaps can be utilized in this procedure, including the Deep Inferior Epigastric Perforator (DIEP) flap, which spares the abdominal muscle by using only the skin and fat while maintaining the blood supply through the deep inferior epigastric artery and vein. The free Transverse Rectus Abdominis Muscle (TRAM) flap, on the other hand, involves the removal of a small portion of the rectus muscle along with the skin and fat, utilizing the same blood vessels. Additionally, the Superficial Inferior Epigastric Artery (SIEA) flap is similar to the DIEP flap but does not require any incision in the rectus muscle, as it uses the superficial inferior epigastric artery. For patients who may not have sufficient abdominal tissue for reconstruction, the Gluteal Artery Perforator (GAP) flap offers an alternative, utilizing skin and fat from the buttocks while preserving the underlying muscle. This comprehensive approach to breast reconstruction aims to achieve optimal aesthetic outcomes while considering the patient's individual circumstances and preferences.