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breast reconstruction

N

nc_coder

Expert
Messages
300
Location
Iron Station, NC
The physician is performing a bilat breast reconstruction with tissue expanders. Since the cancer was removed with the breast, would it be correct to use the dx code 174.9 in this situation? I am also using v45.71.
 
I was instructed by a plastic's coding "guru" that works for a reputable consulting firm to use V10.3 and V45.71 when coding breast reconstruction after mastectomy since the cancer has been removed along with the breast. The surgeon is not actively treating the cancer but is reconstructing the defect after the cancerous breast has been removed. I have never had any problems getting our claims paid when coding these procedures with V10.3 as the primary dx. :)
 
The correct code first listed is V51.0 Encounter for breast reconstruction following mastectomy. You would use the V10.3 if the patient has completed all therapy and there is no evidence of disease, if they are still receiving treatment including adjunctive Tamoxifen then you would the 174.9 secondary. You would not use the V10.3 and the 174.9 together for the same instance of breast cancer.
 
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