Wiki V51.0 vs 174.9

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BlueJades

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I am hoping I can get some input from seasoned Plastics coders. I have a question about the use of V51.0 as a diagnosis code. If the patient had previous bilateral mastectomies for a breast cancer and then comes to have 2nd stage reconstruction done, would V51.0 be appropriate or should I be coding 174.9 even though the patient has no active breast cancer. Any help would be greatly appreciated. Thanks!

Christine M. Schmitz, CPC
 
We also use V45.71 and V10.3, unless they are still taking medication for the cancer then you can bill with a cancer code, rather than history of.
 
I have struggled with this question! I coded 2 stage 2 brst recon surgeries w/ v10.3 as my primary diagnosis and both were denied by 2 different carriers. It opened a huge can of worms and created a lot more work than I had anticipated. I did not use v45.71 however.
 
The problem is that a "History of" dx code is never an acceptable principal dx code. In this case, V45.71 (Acquired Absence of Breast) is.

To respond to the comment above regarding breast cancer being coded if the patient is taking medication.....If a patient is taking Tamoxifen (or some other adjuvant therapy drug), they are taking the medication to prevent a recurrence. It doesn't mean that they still have the cancer.
 
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