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AHA Coding Clinic® for ICD-10-CM and ICD-10-PCS - 2018 Issue 3; Ask the Editor

Deep Inferior Epigastric Artery Perforator Flap Breast Reconstruction

A patient, who is post right mastectomy secondary to breast cancer, was admitted for prophylactic left mastectomy and bilateral deep inferior epigastric artery perforator (DIEP) flap reconstruction. At surgery, skin and subcutaneous tissue were removed from right and left abdominal incisions. The left hemi-abdominal tissue was placed on the left side after removal of the breast. The flap was secured to the chest wall and vessels anastomoses were performed. The right tissue expander was removed from the right mastectomy pocket, and the right hemi-abdominal flap was secured with anastomosis. Should the harvesting of the DIEP flap be coded separately? Additionally, in ICD-10-PCS is a mastectomy with breast replacement/reconstruction analogous to joint replacement surgery, in which the resection of the joint is not coded separately? ...

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