Wiki Z15.01 for HER2+, HER 2 positive

[deskridge]

I'm having trouble understanding why we would code Z15.01 for BRCA and not HER2 (which is is due to a mutation of the HER2 protein). I have presented this to my auditing team, which has been unable to confirm the use of Z15.01 for HER2 with either official AAPC guidance or AHA coding clinic guidance. However, I still believe Z15.01 should be used in this instance, as certain medications are used for HER2 positive patients and the definition of susceptibility seems to be met by BRCA and HER2 mutations.

HER-2 positive means there is "Amplification or overexpression of the human epidermal growth factor receptor 2 (HER2) oncogene."

Meaning the cancer cells, "have a gene mutation that makes an excess of the HER2 protein." This makes the patient more susceptible to aggressive neoplastic growth.

Is this not enough similar verbiage as BRCA 1 and 2 gene mutation to justify Z15.01?

Additionally, 3M Computer Assisting Coding will suggest Z15.01 for "HER-2 Positive" documentation.

1. UpToDate:
https://www.uptodate.com/contents/h...Title=1~150&usage_type=default&display_rank=1


2. Mayo Clinic:
https://www.mayoclinic.org/breast-cancer/expert-answers/faq-20058066

 

[acf7575]

I'm having trouble understanding why we would code Z15.01 for BRCA and not HER2 (which is is due to a mutation of the HER2 protein). I have presented this to my auditing team, which has been unable to confirm the use of Z15.01 for HER2 with either official AAPC guidance or AHA coding clinic guidance. However, I still believe Z15.01 should be used in this instance, as certain medications are used for HER2 positive patients and the definition of susceptibility seems to be met by BRCA and HER2 mutations.

HER-2 positive means there is "Amplification or overexpression of the human epidermal growth factor receptor 2 (HER2) oncogene."

Meaning the cancer cells, "have a gene mutation that makes an excess of the HER2 protein." This makes the patient more susceptible to aggressive neoplastic growth.

Is this not enough similar verbiage as BRCA 1 and 2 gene mutation to justify Z15.01?

Additionally, 3M Computer Assisting Coding will suggest Z15.01 for "HER-2 Positive" documentation.

1. UpToDate:
https://www.uptodate.com/contents/h...Title=1~150&usage_type=default&display_rank=1


2. Mayo Clinic:
https://www.mayoclinic.org/breast-cancer/expert-answers/faq-20058066

I would also like to know a response to this as well. Recently the Estrogen receptor status codes, Z17.0 Estrogen receptor positive status [ER+] and the Z17.1 Estrogen receptor negative status [ER-] were brought to my attention.

I had an example where the provider indicated the patient was HER2 positive left breast cancer, but did not mention the estrogen receptor status. If there are status codes for the estrogen receptor status, why is there not a status code for the human epidermal growth factor receptor 2? If they is one I am missing, can someone please share what it is? Thanks,