The documentation should clearly illustrate the more complex nature of this procedure. A radical mastectomy occurs when the surgeon removes the complete breast, the skin, the pectoralis major muscle, pectoralis minor muscle and the axillary lymph nodes at the same time. The code for this type of more involved mastectomy is 19305.
The code for this type of more involved mastectomy is 19305. When both axillary lymph nodes and the internal mammary lymph nodes are taken during this operative session, the pectoralis major and minor can be spared. If the physician performs this procedure (also known as the Urban-type mastectomy), report 19306.
Asymmetry of breasts; Bilateral mastectomy deformities; Bilateral mastectomy deformity; Bilateral ICD-10-CM Diagnosis Code R68.89 [convert to ICD-9-CM] Other general symptoms and signs
If surgical margins are not addressed specifically, then an excision/biopsy code would be reported instead of a mastectomy code. For female patients, partial mastectomy involves excising the mass from the breast, taking along with it a margin of healthy tissue.
ICD-10 code Z90. 12 for Acquired absence of left breast and nipple is a medical classification as listed by WHO under the range - Factors influencing health status and contact with health services .
Excision of Bilateral Breast, Open Approach ICD-10-PCS 0HBV0ZZ is a specific/billable code that can be used to indicate a procedure.
The breast surgery Current Procedural Terminology (CPT) codes were developed when axillary dissection was standard therapy for breast cancer. Modified radical mastectomy is coded 19307; lumpectomy with axillary dissection is coded 19302.
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.
For example, if you are billing for a bilateral mastectomy, you would report CPT code 19303 (Mastectomy, simple, complete) with the modifier.
Table 2ICD-9-CM and CPT procedure codes defining mastectomiesCodeDescriptionICD-9-CM procedure codes19304Mastectomy, subcutaneous19305Mastectomy, radical19306Mastectomy, radical, urban type15 more rows
Listen to pronunciation. (MAH-dih-FIDE RA-dih-kul ma-STEK-toh-mee) Surgery to remove the whole breast, which may include the nipple, areola (the dark-colored skin around the nipple), and skin over the breast. Most of the lymph nodes under the arm are also removed.
Listen to pronunciation. (RA-dih-kul ma-STEK-toh-mee) Surgery to remove the whole breast, all of the lymph nodes under the arm, and the chest wall muscles under the breast. For many years, radical mastectomy was the type of breast cancer surgery used most often, but it is rarely used now.
ICD-10-CM Code for Intraductal carcinoma in situ of left breast D05. 12.
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.
A mastectomy is surgery to remove a breast. Sometimes other tissues near the breast, such as lymph nodes, are also removed. This surgery is most often used to treat breast cancer. In some cases, a mastectomy is done to help prevent breast cancer in women who have a high risk for it.
To summarize, report code 19303 for a skin-sparing or nipple-sparing mastectomy for diagnosed carcinoma or for patients who are at high risk for carcinoma, regardless of the amount of skin removed or whether the nipple is preserved.
CPT code 19380, Revision of reconstructed breast involves revising an already reconstructed breast. The code includes repositioning the breast; making adjustments to the inframammary crease; making capsular adjustments; and performing scar revisions, fat grafting, liposuction, and so on.
It recommends CPT code 19318 for reduction mammaplasty when breast tissue is removed for breast-size reduction and not for treatment or prevention of breast cancer.
CPT® Code 19350 in section: Repair and/or Reconstruction Procedures on the Breast.
The 2022 edition of ICD-10-CM Z90.12 became effective on October 1, 2021.
Z77-Z99 Persons with potential health hazards related to family and personal history and certain conditions influencing health status
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.
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.
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.