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...
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