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Wiki Mastectomy vs. Acquired absence of Breast

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Shielapsnw

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I work in plastics where we perform the DIEP flap. We see the patient for consult and often are in the OR , consult/during the mastectomy where we make the "pocket" or put in a tissue expander if DIEP is not allowed at that time and then for a few surgeries after that for revisions etc.. my question is when do you use Z42.1 compared to Z90.10 group? On going battle here. Just trying to get it right. And does multiple applications of a wound vac for non healing wounds post op require a modifier? Sometimes we change them once a week. SO appreciate any help! Docs cannot agree.
 
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