How can I ensure that a woman who has had a bilateral mastectomy is not included in the breast cancer screening action list?
If a woman undergoes a bilateral mastectomy in Direct Care or the Network and the procedure was captured electronically in the M2, she should be automatically excluded. However, some women may have undergone bilateral mastectomy prior to the implementation of electronic medical records (1998), or their surgery may have been performed outside the direct care system. In these cases, a coded encounter must be created using the ICD-9-CM code V45.71 with the DOD extension of V45.713 (acquired absence of Bilateral Breasts). Once such a coded encounter is captured by the M2, the patient should be excluded from the HEDIS® denominator, as well as from the Action List. In the Quicklook page, a date of ‘9/9/9999’ in the Mammo column indicates that the woman has been coded as having undergone bilateral mastectomy.
