Question: Our new patient is recovering from a mastectomy for breast cancer in the left breast. We are providing wound care and supervision of exercises. She also has diagnoses of diabetes, hyperlipidemia, arthralgias, osteoarthrosis, senile osteoporosis, chronic obstructive pulmonary disease (COPD), and anxiety. How should we code for her? -- Wisconsin Subscriber Answer: As long as there are no complications from the surgery, you should sequence the aftercare following surgery for neoplasms first. List the breast cancer next, following the aftercare V code because there is nothing to indicate that the cancer has been eradicated. Sequence the other diagnoses to reflect the seriousness of the patient's condition. Don't code for the arthralgias because joint pain is integral to osteoarthrosis. For this patient, you would list the following codes: • M0230a: V58.42 (Aftercare following surgery for neoplasm); • M0240b: 174.9 (Malignant neoplasm of female breast; unspecified) • M0240c: 715.90 (Osteoarthritis, unspecified whether generalized or localized; site unspecified); • M0240d: 496 (Chronic airway obstruction, not elsewhere classified); • M0240e: 300.00 (Anxiety state, unspecified); and • M0240f:733.00 (Osteoporosis, unspecified).