OK, I'm not a surgery coder but will give this one a try. Anyone can feel free to correct me.
For the breast lesion:
Right there are 2 elements of HPI. Is there a duration of how long they've had it? There is another element. Are there any associated signs or symptoms? Possibly another credit for "no breast pain" as a negative to the associated sign or symptom.
For the port placement, can you use the cancer as the chief complaint, since it is the reason for the port? Then you would have the location, duration, severity, etc. If not, what do you use?
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