Wiki ICD-10 Coding: Lumpectomy vs Mastectomy

[rmjanowitz]

I'm trying to determine the appropriate ICD-10 code for a patient who has had a lumpectomy. There only seems to be ICD-10-CM Z-codes for Acquired Absence of Breasts, which would seem to imply removal of the entire breast. How would you code this for a patient who has had a lumpectomy? Or a partial mastectomy? A few other organ removal codes specify removal of "parts of" an organ, but not of the breast or breast tissue. Any help on this, or if someone could point me in the direction of a useful guideline for this, I would super appreciate it.

 

[sls314]

I'm trying to determine the appropriate ICD-10 code for a patient who has had a lumpectomy. There only seems to be ICD-10-CM Z-codes for Acquired Absence of Breasts, which would seem to imply removal of the entire breast. How would you code this for a patient who has had a lumpectomy? Or a partial mastectomy? A few other organ removal codes specify removal of "parts of" an organ, but not of the breast or breast tissue. Any help on this, or if someone could point me in the direction of a useful guideline for this, I would super appreciate it.

If you look in the alphabetic index for Absence, there are also non-essential modifiers listed in parenthesis: (of) (organ or part) (complete or partial)

The full index lookup for acquired absence of breasts would be:

Absence (of) (organ or part) (complete or partial) > breast(s) (and nipple (s)) (acquired) > Z90.1-

The complete or partial would still be captured under that lookup for the Z90.1- code, so that code could be used for status post lumpectomy or mastectomy. Hope this helps!

 

[TThivierge]

Hi Rmjanowitz,
For lumpectomy dx coding.....according to SuperCoder.com "The correct codes for the 12 o'clock position breast mass are N63.22 and N63.21 or N63.11 and N63.12 as per laterality mentioned in document for lumpectomy. They stated to code the beast lump as being in both quadrants, not unspecified". hopefully the provider documented which breast the section of lumpy mass was removed.
I hope this data helps you

Lady T

 

[rmjanowitz]

If you look in the alphabetic index for Absence, there are also non-essential modifiers listed in parenthesis: (of) (organ or part) (complete or partial)

The full index lookup for acquired absence of breasts would be:

Absence (of) (organ or part) (complete or partial) > breast(s) (and nipple (s)) (acquired) > Z90.1-

The complete or partial would still be captured under that lookup for the Z90.1- code, so that code could be used for status post lumpectomy or mastectomy. Hope this helps!

This is exactly what I was looking for! Thank you. Completely missed the (partial) modifier when I was looking through the index.

 

[kpeterson15]

For lumpectomy, we code Z98.890 since just a lump was removed and not part of the breast. For any type of mastectomy, we code to the Z90 area.

 

[rmjanowitz]

For lumpectomy, we code Z98.890 since just a lump was removed and not part of the breast. For any type of mastectomy, we code to the Z90 area.

Interesting. I know in a lumpectomy the idea is to remove the lump and minimal actual healthy breast tissue, but in this case removing the lump in what the physician described as a lumpectomy actually resulted in removing approximately 50% of the tissue from that breast. The line between partial mastectomy and "lumpectomy" seems really blurry. If a lumpectomy results in removal of tissue to where both breasts remain relatively symmetrical, I can see it being weird to call that a mastectomy. However, what percentage of breast tissue (cancerous or otherwise) has to be removed to qualify for partial mastectomy status?