icd 10 code for bilateral breast mastectectomies

Acquired absence of bilateral breasts and nipples. Z90.13 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2019 edition of ICD-10-CM Z90.13 became effective on October 1, 2018. This is the American ICD-10-CM version of Z90.13 - other international versions of ICD-10 Z90.13 may differ.

Full Answer

What is the ICD-10 code for bilateral breast surgery?

0HTV0ZZ is a valid billable ICD-10 procedure code for Resection of Bilateral Breast, Open Approach . It is found in the 2020 version of the ICD-10 Procedure Coding System (PCS) and can be used in all HIPAA-covered transactions from Oct 01, 2019 - Sep 30, 2020 .

What is the ICD 10 code for mastectomy?

ICD-10-CM Code Z90. 11 - Acquired absence of right breast and nipple. What are the types of mastectomy? There are five different types of mastectomy: "simple" or "total" mastectomy, modified radical mastectomy, radical mastectomy, partial mastectomy, and subcutaneous (nipple-sparing) mastectomy.

What is the ICD 10 code for neoplasm of breast?

ICD-10-CM Diagnosis Code C44.501 [convert to ICD-9-CM] Unspecified malignant neoplasm of skin of breast

What is the ICD 10 code for breast reconstruction surgery?

What is the ICD 10 code for mastectomy? Z42. 1 - Encounter for breast reconstruction following mastectomy. ICD-10-CM. Centers for Medicare and Medicaid Services and the National Center for Health Statistics; 2018. Click to see full answer.

What is the ICD-10 code for history of bilateral mastectomy?

Submit the appropriate ICD-10 diagnosis code that reflects a member's history of bilateral mastectomy, Z90. 13.

What is bilateral prophylactic mastectomy?

Bilateral prophylactic mastectomy may involve complete removal of both breasts, including the nipples (total mastectomy), or it may involve removal of as much breast tissue as possible while leaving the nipples intact (subcutaneous or nipple-sparing mastectomy).

What is the difference between a bilateral mastectomy and a double mastectomy?

Double mastectomy When both breasts are removed, it is called a double (or bilateral) mastectomy. Double mastectomy is sometimes done as a risk-reducing (or preventive) surgery for women at very high risk for getting breast cancer, such as those with a BRCA gene mutation.

What is the ICD-10 code for mastectomy?

ICD-10 Code for Encounter for breast reconstruction following mastectomy- Z42. 1- Codify by AAPC.

What is the ICD 10 code for right prophylactic mastectomy?

Z40.01Z40. 01 - Encounter for prophylactic removal of breast | ICD-10-CM.

Are preventative mastectomies covered by insurance?

Insurance coverage No federal laws require insurance companies to cover prophylactic mastectomy. Some state laws require coverage for prophylactic mastectomy, but coverage varies state to state. It's best to check with your insurance company to learn about your plan's coverage. Learn more about health insurance.

What is a bilateral mastectomy surgery?

A mastectomy is used to remove all breast tissue if you have breast cancer or are at very high risk of developing it. You may have a mastectomy to remove one breast (unilateral mastectomy) or both breasts (bilateral mastectomy).

Is bilateral mastectomy major surgery?

A double mastectomy—also known as a bilateral mastectomy—is exactly what it sounds like: a surgery in which both breasts are removed at the same time. It's major surgery that removes both breasts to remove cancer, or to reduce the risk of breast cancer in a woman who may be at high risk for the disease.

When do you need a bilateral mastectomy?

When is bilateral mastectomy recommended? Having both breasts removed is recommended for women at very high risk of breast cancer. For example, those who have tested positive for a breast cancer (BRCA) gene change are at very high risk.

How do you code a bilateral mastectomy?

Report a “1” in the number-of-services field. For example, if you are billing for a bilateral mastectomy, you would report CPT code 19303 (Mastectomy, simple, complete) with the modifier. You would report the service as a single line item: 19303 50.

What is the ICD-10 code for double mastectomy?

Acquired absence of bilateral breasts and nipples The 2022 edition of ICD-10-CM Z90. 13 became effective on October 1, 2021.

How do you code a mastectomy?

Report code 19303, Mastectomy, simple, complete, for the mastectomy.

What is the code for radical mastectomy?

The code for this type of more involved mastectomy is 19305 .

What is subcutaneous mastectomy?

During a subcutaneous mastectomy (19304), the surgeon dissects the breast away from the pectoral fascia and skin. As with the simple complete mastectomy, the surgeon removes all of the breast tissue, but spares the skin and pectoral fascia. The documentation should clearly illustrate the more complex nature of this procedure.

What is a complete mastectomy?

Radical mastectomy. For female patients, partial mastectomy involves excising the mass from the breast, taking along with it a margin of healthy tissue. The title of the procedure will be important when determining the physician’s intention for the procedure.

What is the Women's Health and Cancer Act?

The government passed the Women’s Health and Cancer Act (WHCRA) of 1998, enforcing coverage of reconstruction following mastectomies (if the plan allows for mastectomies). Check with your state’s Department of Insurance for your state’s coverage requirements.

What is the procedure to transfer skin from another part of the body to the breast area?

Three additional reconstruction procedures include transferring skin from another part of the patient’s body to the breast area. The latissimus dorsi flap (19361) describes a procedure during which muscle and skin are taken from the patient’s back and used to reconstruct a breast.

Can breast implants be done at the same time as mastectomy?

Breast implants are, perhaps, the most well-known reconstruction methods. These can be done during the same surgical session as the mastectomy (19340) or at a later time (19342). If reconstruction is delayed, the surgeon may perform a tissue expansion (19357).

Is breast reconstruction surgery risky?

As with any surgery, there are risks to the reconstruction procedures, including the potential removal of the implanted prosthetic if a complication occurs. The size of the breast and the defect may also be factors in deciding which reconstruction method is best for the patient.