mrmetric
New
We did a primary mastectomy (19307-RT) for CA (174.5) and a prophylactic mastectomy on the other side (19303-51-LT) for benign breast mass (611.72). This was denied, but we are not sure why. Should the diagnosis code for the prophylactic mastectomy be V50.41? Also, could problem be with the modifiers? Insurance company isn't saying, and we can't see anything wrong with it.