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Prophylactic mastectomy dx code

  1. Default Prophylactic mastectomy dx code
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    Does anyone know what dx code to use for a prophylactic mastectomy for increased breast cancer risk?

  2. #2
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    Northeast Kansas AAPC
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    I use V07.8 - other specified prophylactic measure as well as their personal or family history that puts them at risk , ie V16.3 or history of self/family ovarian cancer

  3. #3
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    Stuart, Florida
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    Pre-op code:
    V07.8 would be the code you would use if the patient was (in need of) having prophylactic breast removal, as stated in your Tabular List under this code.

    Post-op code:
    However, if the patient has already received the mastectomy, the proper code would be V45.71.

    Hope this helps!
    Vanessa Mier, CPC

  4. #4
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    Columbia, MO
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    V45.71 is secondary only so you would need a post op follow up V67.xx code or an aftercare V58.xx code first.

    Debra A. Mitchell, MSPH, CPC-H

  5. #5
    Location
    Stuart, Florida
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    According to the coding guidelines, in the front of the icd-9-cm book, V45.7X (acquired absence of organ) can be used as 1st and/or an additional dx code. I don't disagree that you should use an aftercare code first, if it is in fact aftercare for the mastectomy, or a follow-up code, if the doctor indicates that it's just routine follow-up of patient with no other DXs to address. I just wanted to point this out in case anyone runs into this in the future.
    Vanessa Mier, CPC

  6. #6
    Location
    Columbia, MO
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    Sorry! you are correct I looked in the wrong column. My apologies and thanks for the correction!

    Debra A. Mitchell, MSPH, CPC-H

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