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Thread: Prophylactic mastectomy w/current ca

  1. #1

    Default Prophylactic mastectomy w/current ca

    AAPC: Back to School
    A patient had a bilateral mastectomy for ca in one breast. The other was removed prophylactically at her request. Would I be correct in coding the ca primary for the right breast and using V50.41 (prophylactic breast removal) primary with the ca code secondary for the left? The path came back negative for that breast. Or, do I use the ca code primary for both? Thanks,
    Sue Vermette, CPC

  2. #2
    Join Date
    Apr 2007
    Bangor, Maine


    I just coded one like this the other day and I spoke to our oncology coder for advice. She told me that since the breast that had cancer was removed, then she was considered to only have a history of cancer, even if she is still doing chemo. So I coded the prophylactic code first and then the history code. I billed it out and received no edits on it and it went through to medicare without fail. I am not completely sure that I agree with it, but this is just my two cents...

  3. #3


    Good to know. Thanks for your two cents!
    Sue Vermette, CPC

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