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Reimbursement Advisor


Total vaginal hysterectomy as prophylaxis

March 2004 · Vol. 16, No. 3

<huc>Q</huc> Genetic testing for a patient with a personal history of breast cancer revealed a high risk for ovarian cancer. She is scheduled to have a total vaginal hysterectomy and bilateral oophorectomy as a precautionary measure. Which diagnosis do I use? She has no signs or symptoms.

<huc>A</huc> Use V50.49 (other prophylactic organ removal), V50.42 (prophylactic organ removal of ovary), and V10.3 (personal history of breast cancer). If you are obtaining prior authorization, submit a letter with the request in which you list these codes as the reason for the surgery and explain the circumstances.

Ms. Witt, former program manager in the Department of Coding and Nomenclature at the American College of Obstetricians and Gynecologists, is an independent coding and documentation consultant. Reimbursement Adviser reflects the most commonly accepted interpretations of CPT-4 and ICD-9-CM coding. When in doubt on a coding or billing matter, check with your individual payer.

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