Name of the Condition

• Other Mechanical Complication of Breast Prosthesis and Implant, Sequela (ICD-10 Code: T85.49XS)

Summary

This condition refers to any subsequent complications arising from issues with breast implants or prostheses that are mechanical in nature, such as displacement, rupture, or deterioration, occurring after the initial episode of the complication has been treated.

Causes

Mechanical complications can occur due to implant rupture, wear and tear over time, improper surgical technique, or trauma to the chest area.

Risk Factors

• Age and older implants
• History of chest trauma
• Underlying health conditions affecting tissue healing
• Previous surgical complications

Symptoms

• Pain or tenderness in the breast area
• Noticeable change in breast shape or size
• Swelling or asymmetry between breasts
• Signs of inflammation or infection around the implant area

Diagnosis

• Physical examination by a healthcare provider
• Imaging tests such as MRI, ultrasound, or mammography to assess the integrity of the implant
• Biopsy if infection or other complications are suspected

Treatment Options

• Surgical intervention to repair or replace the implant
• Medications to manage pain and infection
• Regular monitoring to ensure healing and prevent further issues

Prognosis and Follow-Up

The prognosis depends on the severity of the complication and the individual's overall health. Regular follow-up appointments are crucial to monitor for any additional symptoms or complications.

Complications

• Infection
• Chronic pain
• Increased risk of additional surgery
• Scar tissue formation around the implant (capsular contracture)

Lifestyle & Prevention

• Avoiding high-impact activities that may affect the chest area
• Regular check-ups to monitor implant condition
• Ensuring a healthy lifestyle to support tissue healing

When to Seek Professional Help

• Sudden and severe pain in the breast area
• Noticeable changes in implant position or breast size
• Signs of infection such as redness, warmth, or fever

Additional Resources

• American Society of Plastic Surgeons (https://www.plasticsurgery.org)
• Breastcancer.org for patient support and education

Tips for Medical Coders

• Confirm the documentation specifies the complication is a sequela, as indicated by the "S" in the code’s seventh character.
• Verify the specific mechanical issue is documented to accurately capture the condition in coding.
• Double-check the alignment of the code with additional records for accurate billing and reporting.