1 in 8 women will develop breast cancer in their lifetime. The switch from ICD-9 to ICD-10 brought more specific codes to better define breast cancer based on the location of the cancer in the breast. New codes have been proposed by the ICD-10-CM Committee to further classify BRCA gene mutations, which are indicators of higher risk for breast and/or ovarian cancer. BRCA1 and BRCA2 are genetic mutations that can be detected through a blood or saliva sample.
There has been an increase in insurance carriers covering prophylactic mastectomy and/or oophorectomy for patients at high risk of developing cancer. The need for more specific codes was warranted to identify the specifics of the mutations for tracking and reporting as well as providing better detail for insurance coverage.
The table below depicts the new codes proposed. Oddly, they did not make it into the updates for 2020, but may still be in consideration for future updates.
|Z15.011||BRCA1 genetic susceptibility to malignancy of breast|
|Z15.012||BRCA2 genetic susceptibility to malignancy of breast|
|Z15.019||Genetic susceptibility to malignant neoplasm of breast, unspecified|
|Z15.021||BRCA1 genetic susceptibility to malignancy of ovary|
|Z15.022||BRCA2 genetic susceptibility to malignancy of ovary|
|Z15.029||Genetic susceptibility to malignant neoplasm of ovary unspecified|