General Surgery Coding Alert

Reader Question:

Atypical Hyperplasia of Breast

Question: I have been using ICD-9 code 611.1 for atypical hyperplasia of the breast, but I am not sure it is correct. When the pathology lab reports atypical hyperplasia, the surgeons I work with prescribe tamoxifen. Would neoplasm of uncertain behavior be a better code?

Oregon Subscriber
 
 Answer: Yes. The term atypia suggests that the neoplasm is in transition from benign to malignant, which is what uncertain behavior describes. The correct code, therefore, is 238.3 (neoplasm of uncertain behavior; breast). Code 611.1 (hypertrophy of breast) should be used for females who experience abnormal breast enlargement and for males with gynecomastia, the visible or palpable development of breast tissue.

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