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Hello All,
I work for a plastic surgeon that specializes in Breast reconstruction post mastectomy. I recently passed my CPC exam and have began coding for EM. I also code pre-certs for surgeries. My coders have been taking the lazy route and code C50.911/.912/.919. I am trying to be as accurate as possible and am running into some issues I was hoping someone can help clarify. I have looked into the guidelines of the chapter and can't find a definitive answer.
1. If a neoplasm is listed at 12:00 Left breast, would you code for the UOQ (C50.412), Central Portion (C50.112), UIQ (C50.212) or overlapping sites (C50.812)?
Same question for 3:00 axis of left breast, would it be UOQ, LOQ, Central, or overlapping?
2. If a patient is listed as having DCIS in the UOQ of the left breast, would you code D05.12 in conjunction with C50.412?
3. If a patient is listed as having LCIS in multiple sites of BOTH breasts, would you code D05.01, D05.02 and then add a code for overlapping sites? C50.819 Or would I add the carcinoma for specific quadrant? (IE C50.411) Or would the LCIS codes suffice for each breast?
This is what the med records list:
1. Breast, Right 2:00 1cm from nipple - Invasive ductal carcinoma (No in situ present)
2. Breast, Right 3:00 - Lobular Carcinoma in Situ (LCIS)
3. Breast, Left, Upper Outer Quadrant - LCIS
4. If you have to code for multiple sites, but also need to use a BRCA code, a Deformity code (N65.0), Personal Hx, Family Hx, etc etc....but can only use 4 CPT codes which codes would you code for over the others?
THANK YOU IN ADVANCE!!!
I work for a plastic surgeon that specializes in Breast reconstruction post mastectomy. I recently passed my CPC exam and have began coding for EM. I also code pre-certs for surgeries. My coders have been taking the lazy route and code C50.911/.912/.919. I am trying to be as accurate as possible and am running into some issues I was hoping someone can help clarify. I have looked into the guidelines of the chapter and can't find a definitive answer.
1. If a neoplasm is listed at 12:00 Left breast, would you code for the UOQ (C50.412), Central Portion (C50.112), UIQ (C50.212) or overlapping sites (C50.812)?
Same question for 3:00 axis of left breast, would it be UOQ, LOQ, Central, or overlapping?
2. If a patient is listed as having DCIS in the UOQ of the left breast, would you code D05.12 in conjunction with C50.412?
3. If a patient is listed as having LCIS in multiple sites of BOTH breasts, would you code D05.01, D05.02 and then add a code for overlapping sites? C50.819 Or would I add the carcinoma for specific quadrant? (IE C50.411) Or would the LCIS codes suffice for each breast?
This is what the med records list:
1. Breast, Right 2:00 1cm from nipple - Invasive ductal carcinoma (No in situ present)
2. Breast, Right 3:00 - Lobular Carcinoma in Situ (LCIS)
3. Breast, Left, Upper Outer Quadrant - LCIS
4. If you have to code for multiple sites, but also need to use a BRCA code, a Deformity code (N65.0), Personal Hx, Family Hx, etc etc....but can only use 4 CPT codes which codes would you code for over the others?
THANK YOU IN ADVANCE!!!