I have coded plastic/reconstructive surgery for over 5 years. The primary diagnosis I use was always the breast cancer for the primary diagnosis for initial, staged, and/or complications in breast reconstruction. Have all other diagnosis follow the primary. This leaves no question on the claim that it is medical. This will save you the headache from denials and appeals. There is a book that only plastic surgeons can get called the CPT Corner this book helps with diagnosis and coding of reconstructions, flaps, etc. It is a very useful tool and help with alot of questions in the reconstructive field.
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