Code | Description |
---|---|
ICD-9-CM procedure codes | |
19304 | Mastectomy, subcutaneous |
19305 | Mastectomy, radical |
19306 | Mastectomy, radical, urban type |
Z12.31, Encounter for screening mammogram for malignant neoplasm of breast, is the primary diagnosis code assigned for a screening mammogram. If the mammogram is diagnostic, the ICD-10-CM code assigned is the reason the diagnostic mammogram was performed.
Breast Cancer ICD-10 Code Reference Sheet. FEMALE. Right. C50.011. Malignant neoplasm of nipple and areola, right female breast. C50.111. Malignant neoplasm of central portion, right female breast. C50.211. Malignant neoplasm of upper-inner quadrant, right female breast.
Encounter for breast reconstruction following mastectomy Z42. 1 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2022 edition of ICD-10-CM Z42. 1 became effective on October 1, 2021.
Report code 19303, Mastectomy, simple, complete, for the mastectomy.
ICD-10 Code for Acquired absence of left breast and nipple- Z90. 12- Codify by AAPC.
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 .
In December 2007, an American Medical Association (AMA) CPT [Current Procedure Terminology] Assistant Newsletter article was published indicating that a skin-sparing mastectomy should be reported with CPT* code 19304, Mastectomy, subcutaneous.
CPT 19125 the lesion is identified by preoperative placement of radiological marker. 19301 is a partial mastectomy or lumpectomy. There is also NO radiological marker placement.
2022 ICD-10-PCS Procedure Code 0HBV0ZZ.
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. Breast-conserving surgery (lumpectomy), in which only the tumor is removed from the breast, may be another option.
Lumpectomy is a type of surgery that removes a lump and leaves as much normal breast tissue as possible. During the surgery, the breast cancer and some normal tissue around it is removed. This treatment is also known as a segmental or partial mastectomy.
Code 19380 [Revision of reconstructed breast] is a non-specific code intended to capture revisional procedures other than capsulotomies and capsulectomies. As the code descriptor states, in order to report 19380, the procedures must be performed on a breast that has already been reconstructed.
A simple mastectomy (left) removes the breast tissue, nipple, areola and skin but not all the lymph nodes. A modified radical mastectomy (right) removes the entire breast — including the breast tissue, skin, areola and nipple — and most of the underarm (axillary) lymph nodes.
For example, if you are billing for a bilateral mastectomy, you would report CPT code 19303 (Mastectomy, simple, complete) with the modifier.
The code for this type of more involved mastectomy is 19305 .
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.
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.
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.
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).
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.
While some excisions may be performed for benign conditions, most mastectomies are performed for malignancy. About two-thirds of breast cancers require estrogen to thrive, and can therefore be managed with estrogen-blocking drugs. These drugs reduce the chance of the cancer recurring and improve survival rates.