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Encounter for breast reconstruction following mastectomy

ICD10CM code

Medical Policies and Guidelines for Encounter for breast reconstruction following mastectomy

Related policies from health plans

ANC.00009 Cosmetic and Reconstructive Services of the Trunk, Groin, and Extremities
SURG.00023 Breast Procedures; including Reconstructive Surgery, Implants and Other Breast Procedures
SURG.00023 Breast Procedures; including Reconstructive Surgery, Implants and Other Breast Procedures

Similar Codes


ICD10CM codes

Z42.1 - Encounter for breast reconstruction following mastectomy
Z42 - Encounter for plastic and reconstructive surgery following medical procedure or healed injury
Z44.3 - Encounter for fitting and adjustment of external breast prosthesis
Z42.8 - Encounter for other plastic and reconstructive surgery following medical procedure or healed injury
Z45.81 - Encounter for adjustment or removal of breast implant
Z44.31 - Encounter for fitting and adjustment of external right breast prosthesis
Z40.01 - Encounter for prophylactic removal of breast
Z12.3 - Encounter for screening for malignant neoplasm of breast
Z44.32 - Encounter for fitting and adjustment of external left breast prosthesis
Z45.812 - Encounter for adjustment or removal of left breast implant

HCPCS codes

L8010 - Breast prosthesis, mastectomy sleeve
L8020 - Breast prosthesis, mastectomy form
L8015 - External breast prosthesis garment, with mastectomy form, post mastectomy
L8002 - Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, bilateral, any size, any
L8035 - Custom breast prosthesis, post mastectomy, molded to patient model
L8001 - Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, unilateral, any size, any
C1789 - Prosthesis, breast (implantable)
L8000 - Breast prosthesis, mastectomy bra, without integrated breast prosthesis form, any size, any type
G9774 - Patients who have had a hysterectomy
G8875 - Clinician diagnosed breast cancer preoperatively by a minimally invasive biopsy method

CPT4 codes

19342 - Insertion or replacement of breast implant on separate day from mastectomy
19366 - Breast reconstruction with other technique
19303 - Mastectomy, simple, complete
19340 - Insertion of breast implant on same day of mastectomy (ie, immediate)
19300 - Mastectomy for gynecomastia
19364 - Breast reconstruction; with free flap (eg, fTRAM, DIEP, SIEA, GAP flap)
19380 - Revision of reconstructed breast (eg, significant removal of tissue, re-advancement and/or re-inset
19370 - Revision of peri-implant capsule, breast, including capsulotomy, capsulorrhaphy, and/or partial caps
19361 - Breast reconstruction; with latissimus dorsi flap
19350 - Nipple/areola reconstruction