THE CODING EDGE® ARCHIVES

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Procedure Practice 11/15/99 - Feature Article 11/15/99
   

Procedure Practice 11/15/99:
Coding Recommendations

  
Listed below are the ICD-9-CM diagnosis and procedure codes as well as the CPT-4 procedure codes that we think properly classify the treatment described. Please note that modifiers, used only for physician billing purposes, have not been assigned to the CPT-4 codes. If you disagree with our suggestions or have other comments, please send an e-mail to  codingedge@lagunamedsys.com.
   

Suggested Codes and Rationale
   

Diagnosis Codes

The patient was admitted for delayed plastic reconstruction of her right breast following mastectomy for breast malignancy. She also had a left breast augmentation for cosmetic purposes.
  

ICD-9-CM Code(s)  
Tabular List Narrative		  
Alphabetic Index Heading
V51 Aftercare involving use of plastic surgery Admission for plastic surgery following healed injury or operation
V45.71 Acquired absence of breast Absence, breast, acquired
V10.3 Personal history of malignant neoplasm of breast History (personal) of malignant neoplasm of breast
V50.1 Other plastic surgery for unacceptable cosmetic appearance Admission for breast augmentation or reduction

  

Procedure Codes

The patient underwent tissue expander insertion at the site of her previous mastectomy. She also had insertion of a breast implant for augmentation of the left breast.
  

ICD-9-CM Code(s)  
Tabular List Narrative		  
Alphabetic Index Heading
85.95 Insertion of breast tissue expander Insertion, tissue expander, breast
85.53 Unilateral breast implant Implant, breast, unilateral
CPT-4 Code(s)  
Tabular List Narrative		  
Alphabetic Index Heading
19357 Breast reconstruction, immediate or delayed, with tissue expander, including subsequent expansion Reconstruction, breast, with tissue expander
19325 Mammoplasty, augmentation, with prosthetic implant Mammoplasty, augmentation

  

Procedure Practice 11/15/99 - Feature Article 11/15/99
   

Bibliography - References:
Coders' Desk Reference 1999, Medicode, Salt Lake City, UT
CPT-4 1999, American Medical Association, Chicago, IL
CPT Assistant, Jan. 1996, Aug. 1996, American Medical Association, Chicago, IL
CPT Companion, 1998, American Medical Association, Chicago, IL
ICD-9-CM Coding Clinic, 4th Qtr. 1995, 3rd Qtr. 1997, 2nd Qtr. 1998, American Hospital Association, Chicago, IL
St. Anthony's Illustrated ICD-9-CM Code Book, St. Anthony Publishing, Inc. Reston, VA		 Notice: This part of our web site was prepared to assist in understanding and maintaining good coding skills. For proper use of this feature, reference must be made to official coding guidelines when necessary. The information here presented is only to be used as a supplement to those guidelines. Laguna Medical Systems, Inc., makes no representations or guarantees as to amounts that will be paid by Medicare or other third party payers.

 

Please be aware that the Coding Edge® Archive pages are NOT retroactively updated
to reflect possible coding rules and regulation changes made after the publishing date.