Encounter for breast reconstruction following mastectomy ICD-10-CM Diagnosis Code Z90.13 [convert to ICD-9-CM] Acquired absence of bilateral breasts and nipples
These exams are vital to a patient that has had cancer, completed treatment, and is currently free of the disease. Our doctors are still going to do the scope even if the payers policy states that a history code is not a valid diagnosis for the procedure. We have the most denials from Humana for this issue.
Acquired absence of bilateral breasts and nipples. 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.
According to the ICD-10 guidelines, (Section I.C.2.m): When a primary malignancy has been excised but further treatment, such as additional surgery for the malignancy, radiation therapy, or chemotherapy is directed to that site, the primary malignancy code should be used until treatment is complete.
Excision of Bilateral Breast, Open Approach ICD-10-PCS 0HBV0ZZ is a specific/billable code that can be used to indicate a procedure.
Z40.01Z40. 01 - Encounter for prophylactic removal of breast | ICD-10-CM.
Z85. 3 - Personal history of malignant neoplasm of breast | ICD-10-CM.
13: Acquired absence of bilateral breasts and nipples.
ICD-10 code Z40. 01 for Encounter for prophylactic removal of breast is a medical classification as listed by WHO under the range - Factors influencing health status and contact with health services .
19303Report code 19303, Mastectomy, simple, complete, for the mastectomy.
Patients with history of malignant neoplasm, and not currently under treatment for cancer, and there is no evidence of existing primary malignancy, a code from category Z85, personal history of malignant neoplasm, should be used. Breast Cancer Scenario: Should be coded as historical (Z85.
C50 Malignant neoplasm of breast.
In-active neoplasm or cancer is coded when a patient is no longer receiving treatment for cancer and the cancer is in remission by using the V “history of” code (“Z” code for ICD-10).
1 for Encounter for breast reconstruction following mastectomy is a medical classification as listed by WHO under the range - Factors influencing health status and contact with health services .
For example, if you are billing for a bilateral mastectomy, you would report CPT code 19303 (Mastectomy, simple, complete) with the modifier.
A mastectomy is surgery to remove all breast tissue from a breast as a way to treat or prevent breast cancer. For those with early-stage breast cancer, a mastectomy may be one treatment option.