Gene Mutation dx codes

nlbarnes

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Escondido, CA
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I have the guidelines from the ICD-10, however I don't have another dx of either #1 or #3. I'm getting a claim edit preventing the claim to go.


1st - first-listed code should be a code from category
Z40, encounter for prophylactic surgery,

2nd - followed by the
appropriate codes to identify the associated risk factor (such as
genetic susceptibility or family history.

3rd - If the patient has a malignancy of one site and is having
prophylactic removal at another site to prevent either a new
primary malignancy or metastatic disease, a code for the
malignancy should also be assigned in addition to a code from
subcategory Z40.0, Encounter for prophylactic surgery for risk
factors related to malignant neoplasms. A Z40.0 code should
not be assigned if the patient is having organ removal for
treatment of a malignancy, such as the removal of the testes for
the treatment of prostate cancer.

Assessment
1. MLH1 gene mutation (V84.89) (Z15.89)
2. Genetic predisposition to cancer (V84.09) (Z15.09)

Plan
Genetic predisposition to cancer
1. GASTROENTEROLOGY Consult Only 36 year old female who requested genetic testing
due to a mother with uterine cancer and she was found to have a
germline MLH1 mutation which is consistent with Lynch syndrome. Please do
colonoscopy and EGD for screening and arrange future screening for patient.
 
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You'd need to use a primary diagnosis explaining the reason for the encounter. If the consult led to the discovery of the gene mutation, maybe Z13.79 Encounter for other screening for genetic and chromosomal anomalies?
 
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