Gyno 19140 vs. excision 19120

[superdow]

My 18 year-old son had surgery performed on his left breast in January. Although my Cigna HMO excludes gynecomastia (Code 19140) from coverage, the symptoms it seems to me were atypical of gynecomastia .Two large, isolated lumps (one under the nipple) were present in the tissue of the breast and were hard rather than soft. The surgeon indicated that one of the masses was among the largest that he had ever removed. Mammogram was done pre-op and biopsies of the masses were performed after the operation. This appears more in the nature of a covered Code Sec. 19120 procedure, relating to the excision of cyst, fibroadenoma, or other benign or malignant tumor, ABERRANT BREAST TISSUE, nipple or areolar lesion (except 19140), open, male or female, one or more lesions is a covered procedure “when medically necessary.  

Has anyone faced this issue. Any tips on approaching insurance company. The procedure was submitted by the doctor's office as a 19140 gynomastia but the doctor now agrees that it is a 19120 and will resubmit under that code.

[superdow]

The total bill was $10,000. $750 for surgeon, $900 for anesthesiologist and $7,500 for hospital.