AHA Coding Clinic® for ICD-9 - 2012 Issue 2; Ask the Editor

Removal of Transverse Rectus Abdominis Myocutaneous (TRAM) Flap

The patient had previously undergone transverse rectus abdominis myocutaneous (TRAM) reconstruction of left breast secondary to ductal carcinoma. She developed a recurrent left chest wall malignancy consistent with infiltrating ductal carcinoma, status post excision x2. However, the margins were still positive for infiltrating ductal carcinoma. The patient is now undergoing removal of her reconstructed breast on the left, to achieve surgically negative margins. What is the appropriate procedure code for removal of TRAM flap due to recurrence of the malignancy? ...

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