Wiki More specific code for Deformity of Reconstructed breast

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KylieMarlette

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Tricare denied a claim for a patient stating that N65.0 was not specific enough.....any body have any idea as to what would be more specific?

OP NOTES:

Procedure: bilateral Breast fat grafting w/ 60 mL injected into the left breast and 70 mL injected into the right breast
Diagnosis:
Personal History of breast cancer and contour irregularity of bilateral reconstructed breasts

Patient had significant scar tissue deep in the skin- which prevented a very large volume of fat grafting in the pre-marked areas- they were able to improve her contour....:confused:
 
Is the history of breast cancer dx on there as well? N65.0 is not post breast cancer specific and can also mean deformity from a non covered cosmetic reconstruction too.
 
In addition to the history of breast cancer DX, perhaps a Z42- code could be used as well...?
 
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