Billing and Coding: Plastic Surgery (A57221) - R5 - Effective October 1, 2022

This coverage article has been revised and published for notice under contract numbers: 01112 (NCA), 01182 (SCA), 01212 (HI and Territories), and 01312 (NV).

Effective Date: October 1, 2022

Summary of Article Changes: Updated Group 4: Medical Necessity ICD-10-CM Codes Asterisk Explanation to say: When billing for surgery on the unaffected breast to restore symmetry following breast cancer surgery on the contralateral breast, N65.1 must be used as the primary diagnosis with one of the C50.XXX ICD-10 codes as a secondary diagnosis.

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            Last Updated Thu, 03 Nov 2022 13:30:39 +0000