Acquired absence of left breast and nipple Z90. 12 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 Z90. 12 became effective on October 1, 2021.
Encounter for prophylactic removal of breast Z40. 01 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 Z40. 01 became effective on October 1, 2021.
11.
174.9ICD-9 Code 174.9 -Malignant neoplasm of breast (female) unspecified site- Codify by AAPC.
Personal history of malignant neoplasm of breast. Z85. 3 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes.
D05. 1 - Intraductal carcinoma in situ of breast | ICD-10-CM.
Oncologic resection with attention to margins (lumpectomy or partial mastectomy), code 19301, describes the procedure where margin status is indicated by any method and may include excision of additional surrounding tissue for margins.
Listen to pronunciation. (lum-PEK-toh-mee) Surgery to remove cancer or other abnormal tissue from the breast and some normal tissue around it, but not the breast itself. Some lymph nodes under the arm may be removed for biopsy.
Lumpectomy is also called breast-conserving surgery. Lumpectomy is a commonly performed surgery but still major surgery with risks and potential complications. Later on, additional treatments may be required following a lumpectomy such as chemotherapy and radiation therapy.
The ICD-10 code range for Neoplasms C00-D49 is medical classification list by the World Health Organization (WHO).
About 1 in 5 new breast cancers will be ductal carcinoma in situ (DCIS). Nearly all women with this early stage of breast cancer can be cured. DCIS is also called intraductal carcinoma or stage 0 breast cancer.
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.
ICD-10-CM Code for Encounter for surgical aftercare following surgery on specified body systems Z48. 81.
Z48. 81 - Encounter for surgical aftercare following surgery on specified body systems. ICD-10-CM.
Oncologic resection with attention to margins (lumpectomy or partial mastectomy), code 19301, describes the procedure where margin status is indicated by any method and may include excision of additional surrounding tissue for margins.
Listen to pronunciation. (lum-PEK-toh-mee) Surgery to remove cancer or other abnormal tissue from the breast and some normal tissue around it, but not the breast itself.
The code for this type of more involved mastectomy is 19305 .
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.
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.
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.
The correct codes and modifiers to report for these procedures are: 19307-LT, 19328-59-RT.
Tru-Cut soft-tissue biopsy needles are considered core needles. So the correct code to report for this procedure is 19100, Biopsy of breast; percutaneous, needle core, ...
However, removal of the implant in the right breast is a distinct operation. Because there is a code pair edit for 19307 and 19328, modifier 59, Distinct procedural service, is used instead of modifier 51, Multiple procedures. The correct codes and modifiers to report for these procedures are: 19307-LT , 19328-59- RT. NCCI edits are available online.
A patient with bilateral breast implants develops breast cancer in the left breast and undergoes a modified radical mastectomy of the left breast with removal of the bilateral implants.
The surgeon performed a partial mastectomy on one breast, but actually made two separate smaller incisions to remove two separate lesions (lumpectomy) from different non-contiguous areas of the breast.
Modifier 26, Professional component, is appended to the imaging code when the services are performed in a facility setting. If an imaging service is performed in an office setting, then no modifier is appended because both the professional and technical components apply.
The catheter and port placement is reported with code 36561, Insertion of tunneled centrally inserted central venous access device, with subcutaneous port; age 5 years or older. Append modifier 79, Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period, to code 36561. It would be inappropriate to append modifier 58, Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period, to code 36561 because the port is in a different anatomic location and is not a staged or more extensive procedure to the mastectomy.