Wiki revision of mastectomy?!! plz help

trishj12

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A patient had a double mastectomy - 19307-LT DX: 174.9 and 19303-RT DX: 611.71 V50.41 V84.01. Pt is currently undergoing chemo and will be NOT be having breast reconstruction until ok'd by oncology, probably in another year. My question is how to code an unplanned excision of excess skin and tissue during the global period. I have considered using the same mastectomy codes with the same dx's with a -78 (my theory being it is revision of the same procedure although unplanned). I have also considered 21556-78 using the same dx codes or with V10.3. The procedure has not been performed yet so I do not have an operative note. The purpose of the tissue excision is basically cosmetic and to correct assymetry. The op note and path report, when completed, will be more definitive.

Please share your thoughts and direction.

Thanks!
 
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