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Need help coding BRCA 1

  1. Default Need help coding BRCA 1
    Medical Coding Books
    Patient is being seen for breast reconstruction following risk reduction mastectomy. Patient is BRCA-1 positive. Would you add modifier OA to the E/M code or are there any other codes that you would use.

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    Quote Originally Posted by khdalton View Post
    Patient is being seen for breast reconstruction following risk reduction mastectomy. Patient is BRCA-1 positive. Would you add modifier OA to the E/M code or are there any other codes that you would use.
    0A is a genetic testing code modifier, to be used with 83890-83916, 88230-88299, or other molecular & cytogenic studies. It is not to be appended to the mastectomy codes. Rather, you would show her BRCA-1 positive status with diagnosis code V84.01, genetic susceptibility to malignant neoplasm of the breast. See the instructions with that code as to code first and code additional.

    Hope this helps,
    Lucinda (Cindy) McGarry, CPC-P
    Applications Specialist
    Avera Health Plans
    Education Office Sioux Falls SD Local Chapter
    Past President Sioux Falls SD Local Chapter

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