CPT code 19324: deleted mammaplasty code and what to use instead

Key takeaways

CPT code 19324 described mammaplasty, augmentation without prosthetic implant, and the AMA deleted it effective January 1, 2021.

Code 19324 has no direct one-to-one successor, so there is no valid crosswalk from it to a single current code.

The AMA’s deletion note directs coders to report breast augmentation with fat grafting using 15771 and add-on code 15772.

Codes 19325, 19340, and 19342 all require a prosthetic implant, so none of them replaces 19324.

Practice management software like Pabau keeps your charge list, clinical notes, and claim submission in one system, so a code update reaches billing immediately.

What CPT code 19324 covered before it was deleted

CPT code 19324 described mammaplasty, augmentation; without prosthetic implant. The American Medical Association (AMA) deleted the code effective January 1, 2021. Any claim carrying 19324 for a service on or after that date will be denied.

Code 19324 has no direct one-to-one successor. The AMA attached a parenthetical instruction to the deletion. To report breast augmentation with fat grafting, it points coders to 15771 and add-on code 15772.

This article covers the code’s history and the correct reporting pathway today. It also covers the codes commonly mistaken for successors. Modifiers, coverage, and documentation rules follow, for plastic surgery practices and regenerative medicine practices alike.

CPT code 19324 sat in the integumentary system section (codes 10000-19999), inside the breast surgery subsection. Its official descriptor was: Mammaplasty, augmentation; without prosthetic implant.

It applied to procedures that enlarged or reshaped the breast using the patient’s own tissue rather than a silicone or saline implant. In practice, that meant autologous fat grafting. Because the procedure is overwhelmingly cosmetic, coverage was rarely available under Medicare or commercial payers.

Why was CPT code 19324 deleted?

The AMA deleted CPT code 19324 in the 2021 CPT revision cycle, which reworked the breast surgery code set. The stated aim was to simplify and streamline the language across the section. Autologous fat grafting already had its own family of codes, which made a separate breast-only augmentation code redundant.

• Fat grafting already had codes: the 15771 to 15774 family describes autologous fat grafting by anatomic site group, and that group includes the breasts.
• Language simplification: descriptors across the breast section replaced the word prosthesis with implant and dropped redundant phrasing.
• Clearer separation: the breast codes that remain all describe implant-based work, while fat grafting sits with the other grafting codes.
• Effective date: the deletion took effect January 1, 2021. Code 19324 has no valid use for services on or after that date.

A charge master that still listed 19324 in January 2021 kept feeding an invalid code onto claims. The transition still matters today, because old encounters, resubmissions, and audits involving this code continue to surface.

What replaced CPT code 19324?

Nothing replaced CPT code 19324 on a one-to-one basis. The AMA never mapped it to a single new code, so no crosswalk from 19324 is valid. What it published instead was a parenthetical instruction pointing coders to the fat grafting codes. That instruction is the reporting pathway for the procedure 19324 used to describe.

Important: 15771 and 15772 are not breast-specific codes. Their descriptor covers a group of anatomic sites, so injectate volume drives the units, not the body part. Do not treat 19325, 19340, or 19342 as substitutes for 19324. Each of those requires a prosthetic implant, which is the opposite of what 19324 described.

How to report breast augmentation with fat grafting today

Fat grafting to the breast is reported by volume, not by breast. Report 15771 for the first 50 cc of injectate. Then report one unit of add-on code 15772 for each additional 50 cc, or part thereof.

Counting injectate volume

CPT instructs coders to sum the total injectate volume across the anatomic sites that share one descriptor. Because 15771 groups the trunk, breasts, scalp, arms, and legs together, grafting to both breasts in one session is added together. A 140 cc bilateral case is therefore 15771 plus two units of 15772. It is not two separate primary codes.

Bilateral cases and modifier 50

Volume-based units already account for both breasts, so modifier 50 is usually inappropriate on 15771. Check the payer’s policy before you add it. Appending modifier 50 to a code already reported by total volume invites a duplicate-billing denial.

What the graft codes already include

The descriptor for 15771 covers fat harvested by liposuction technique, so the donor-site harvest is part of the code. Do not report a separate lipectomy code for that harvest. Document the donor site, the harvest technique, the preparation method, and the measured injectate volume for each side.

Why 19325, 19340, and 19342 are not replacements for 19324

These three codes were revised in the same 2021 update, which is why they are often mistaken for successors to 19324. They are not successors. Every one of them describes placing a prosthetic implant, and 19324 described augmentation without one.

Billing 19325 for a fat-grafting augmentation misstates the procedure performed. If the operative report documents no implant, the claim does not match the code. On a post-payment review that mismatch reads as an overpayment, and the payer can recoup it.

Modifiers for breast augmentation and fat grafting claims

Because 19324 is no longer billable, modifier decisions now belong to the codes that carry its clinical work. The table below covers the modifiers that come up most often on breast augmentation and fat grafting claims.

Modifier selection depends on payer policy, the specific procedure, and the clinical circumstances. Treat this table as a starting point, then verify against the payer’s coverage policy before submission. Some payers restrict modifier 50 on bilateral cosmetic procedures. Check the CMS Physician Fee Schedule for the current bilateral surgery indicator on whichever code you bill.

Reimbursement and payer coverage

Reimbursement data for CPT code 19324 is historical only. No current fee schedule carries a value for it, because the code has not been valid since January 1, 2021.

Codes 15771 and 15772 do carry Medicare relative value units. But a fee schedule value is not the same as coverage. Look up current figures in the CMS Physician Fee Schedule rather than a cached rate.

Medicare coverage

Medicare does not cover cosmetic breast augmentation, and that exclusion applies whichever code you use. According to CMS coding guidance, procedures performed solely to improve appearance are statutory exclusions from coverage. Reconstructive breast procedures after mastectomy or trauma may qualify, but they require clear documentation of medical necessity.

Commercial payer policies

Most commercial payers classify breast augmentation as cosmetic and non-covered. Coverage exceptions exist only where augmentation forms part of breast reconstruction after mastectomy and meets the criteria in the payer’s medical policy. Practices billing reconstructive breast procedures should obtain prior authorization before scheduling.

Switching from 19324 to 15771 changed the code, not the coverage. A purely cosmetic fat-grafting augmentation remains a self-pay procedure under almost every plan. Where a case is reconstructive, the authorization has to be on file before surgery, not requested after the claim denies.

Cosmetic vs reconstructive: what the classification changes

The most consequential variable in breast augmentation billing is whether the procedure counts as cosmetic or reconstructive. That distinction drives coverage, documentation requirements, and potential liability. The classification is decided in the chart, before anyone picks a code. For med spa compliance and surgical billing teams, that means the physician’s note comes first.

• Cosmetic classification: performed primarily to improve appearance. Medicare and most payers do not cover it. The patient pays out of pocket and no insurance claim is appropriate.
• Reconstructive classification: performed to restore form after disease, trauma, or a congenital abnormality. It may be covered if clinical criteria are met, and prior authorization is typically required.
• Physician documentation drives the classification: the treating physician must state in the operative report why the procedure is reconstructive rather than cosmetic. Vague documentation defaults to cosmetic.
• Post-mastectomy reconstruction: under the Women’s Health and Cancer Rights Act, group health plans that cover mastectomy must also cover reconstructive surgery, including augmentation for symmetry.

Never reclassify a cosmetic procedure as reconstructive to obtain coverage. Doing so constitutes fraud. The documented clinical judgment of the physician determines the classification, and billing staff should not override or reinterpret it.

ICD-10 diagnosis codes for reconstructive breast claims

A reconstructive breast claim needs a diagnosis code that supports medical necessity. Cosmetic augmentation does not, because no claim goes to a payer. The codes below are the ones that come up most often on reconstructive breast claims.

Sequence the diagnosis that establishes medical necessity first. Verify every code against the current ICD-10-CM tabular list before submission, because annual updates change descriptors and add subcodes.

Common coding errors and how to avoid them

The errors below account for most of the denials and audit findings tied to this deleted code. Each one is preventable at the point of coding.

• Crosswalking 19324 to 19325. This is the most common error. It puts a prosthetic implant on a claim where none was placed.
• Leaving 19324 in the charge master. Staff select it from a stale list and the payer rejects the claim as an invalid code.
• Reporting 15771 twice for a bilateral case. Volume is summed across both breasts, so the second side is billed with 15772 units.
• Billing the donor-site liposuction separately. The harvest sits inside the 15771 descriptor and is not separately reportable.
• Omitting injectate volume from the operative note. Without a measured volume, the 15772 units cannot be supported on audit.
• Reading a fee schedule value as coverage. Cosmetic augmentation stays non-covered whichever code appears on the claim.

Documentation requirements for breast augmentation billing

Documentation requirements are strict whether you bill cosmetic augmentation as self-pay or reconstructive augmentation to a payer. Incomplete records are what turn a correctly coded claim into a denial on review. Medical forms workflows that capture structured pre-operative data leave less for a reviewer to question.

Use the checklist below as a minimum standard. Payer-specific requirements may be more extensive.

• Operative report documenting surgical technique, tissues involved, and clinical rationale
• Measured injectate volume per side, where fat grafting was performed
• Donor site and harvest technique for any autologous fat graft
• Pre-operative consultation note with patient history and clinical indication
• Reconstructive intent explicitly stated by the treating physician, for reconstructive claims
• Prior authorization reference number and correspondence, where required
• Diagnosis codes supporting medical necessity, for reconstructive procedures
• Photographs documenting the pre-operative condition, required by many payers on reconstructive claims
• Pathology report confirming mastectomy or the underlying condition, in reconstructive cases

Practices using digital intake forms can structure pre-operative documentation to capture every required field at the point of care. That cuts the back-and-forth of chasing records during the billing cycle. Teams handling HIPAA-compliant documentation get the audit trail in the same place. The record shows who filled in what, and when.

Related breast CPT codes that are still active

CPT code 19324 sat within a broader range of breast procedure codes. The table below lists the active codes most relevant to augmentation, grafting, and reconstruction billing. Use the AAPC CPT code lookup for full descriptors and recent updates.

The same code range carries the diagnostic and drainage procedures for the breast. Codes 19000 and 19020 follow different reporting rules from the grafting codes above. Both describe therapeutic work, so coverage turns on medical necessity rather than being ruled out as cosmetic.

How Pabau stops a deleted code from reaching a claim

Charge masters and billing workflows do not update themselves when the AMA revises the CPT set. Practices running on spreadsheets or a disconnected billing tool had no way to catch 19324 on its way out the door. Somebody had to remember, every January.

Practice management software like Pabau keeps the clinical record and the billing record in one system. The operative note, the consent form, the coded charge, and the claim all sit against the same patient file. When you retire a code, you change it in one place, and every future charge picks up that change.

That single source of truth is what makes an annual CPT update manageable for a plastic surgery EMR team. Your staff stops reconciling a spreadsheet against a superbill. For US practices, our claims management integration submits and tracks claims from the same record. The coded charge on the invoice is what reaches the payer.

Teams comparing plastic surgery software or broader practice management software should check how each system handles annual code set changes. A platform that leaves code maintenance in a separate spreadsheet puts the compliance burden back on your staff.

Keep coding and documentation in one system

Pabau connects clinical notes, consent forms, coded charges, and claim submission in one patient record. Your team updates a code once and every future charge follows, which cuts avoidable rework for plastic surgery practices.

Book a demo

Conclusion

If 19324 is still sitting in your charge master, retire it now rather than hunt for a substitute. Route the fat-grafting augmentation it used to describe to 15771, then add the units of 15772 the total volume calls for.

The trap worth remembering is the implant codes. Codes 19325, 19340, and 19342 were revised in the same update, which makes them look like successors. All three require a prosthetic implant, so billing one for a fat-grafting case misrepresents the surgery performed.

Coverage did not change with the code. Cosmetic augmentation stays self-pay, and the physician’s documented clinical judgment still decides whether a case is reconstructive.

Keep the code list, the operative note, and the claim in one system, and a retired code cannot resurface. Book a demo to see how Pabau keeps coding and documentation aligned for plastic surgery practices.

Continue your research

Coding other breast procedures? 19000 sets out the reporting rules for puncture aspiration of a breast cyst.

Aspirating more than one cyst in a session? 19001 explains how the add-on units stack and what the note must show.

Draining a breast abscess? 19020 covers mastotomy reporting and the documentation a therapeutic claim needs.

Offering nonsurgical alternatives? Nonsurgical breast lift walks through the treatment options and the consent form to pair with them.

Standardizing your post-operative paperwork? Patient discharge form gives you a free template and the fields a discharge record should carry.

Frequently asked questions