Identifying Mastectomies in Claims Data
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Corresponding Organization :
Other organizations : Washington University in St. Louis, Wilmington University
Protocol cited in 5 other protocols
Variable analysis
- Mastectomy operations with at least one day follow-up after operation
- Women aged 18–64 years
- Time period: 1/1/2004–12/31/2011
- Identification of true mastectomy procedures
- ICD-9-CM and/or CPT-4 procedure codes from inpatient and outpatient facility and provider claims
- Maximum of two mastectomies per woman during the study period
- Exclusion of claims with truncated procedure codes or single-line mastectomy procedures
- Algorithm to determine the most likely procedure in cases of concurrent BCS and mastectomy
- Procedure code for reconstruction
- CPT-4 pathology code 88309 (modified radical mastectomy)
- Prophylactic removal of the breast (V50.41)
- Mastectomy coded by both facility and surgeon
- BCS and mastectomy on opposite breasts per CPT-4 modifier codes
- BCS coded only by an assistant surgeon
- Diagnosis of acquired absence of the breast in the year following surgery (V45.71)
- Procedures more consistent with BCS, including surgeon coding only for BCS (mastectomy-only coded by assistant surgeon or facility)
- Other diagnoses and procedures consistent with BCS but not mastectomy
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