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Wiki Breast Reconstruction

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RobinSewell

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Does anyone know the correct ICD-10 diagnoses to use for breast reconstruction after cancer? We have a denial for more specificity when using C50.911. The cancer has already been removed so I am thinking it should be a Z code but I cannot find a coverage policy/
Thank you in advance !
 
answer for DX for Breast Reconstruction

I would code Z85.3 for Personal HX of Malignant Breast Cancer and Z42.1 for Encounter for Breast reconstruction for deformity.

The code C50.911 is incorrect since the patient has already had a mastectomy and should no longer be diagnosed as having Breast CA.

I hope this helps.

Donna Fine, CPC:)
 
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