Operative Category | ICD-9-CM Procedure Code | CPT-4 or HCPCS Procedure Code |
---|---|---|
Mastectomy* | 85.41–85.48 | 19180, 19200–19240, 19303, 19305–19307 |
Breast implant | 85.33, 85.35, 85.53, 85.54, 85.95 | 19325, 19340, 19342, 19357 |
Flap reconstruction | 85.7–85.79, 85.85 | 19361, 19364, 19367–19369, S2066–S2068 |
CPT-4 indicates Current Procedural Terminology, 4th edition; HCPCS, Healthcare Common Procedure Coding System; ICD-9-CM, International Classification of Diseases, 9th Revision, Clinical Modification.
For mastectomy coded by facility- or provider-only, a code for anesthesia (CPT-4 00400– 00406), pathology (CPT-4 88307, 88309), or a surgery revenue code (Uniform Billing 0201, 0360, 0361, 0369, 0370, 0379, 0490, 0499, 0963, 0964, 0975) was required as evidence for surgery.