The new codes are for describing the infusion of tixagevimab and cilgavimab monoclonal antibody (code XW023X7), and the infusion of other new technology monoclonal antibody (code XW023Y7).
Why ICD-10 codes are important
Search the full ICD-10 catalog by:
The ICD-10-CM (International Classification of Diseases, Tenth Revision, Clinical Modification) is a system used by physicians and other healthcare providers to classify and code all diagnoses, symptoms and procedures recorded in conjunction with hospital care in the United States.
Listen to pronunciation. (ES-truh-jin reh-SEP-ter PAH-zih-tiv) Describes cells that have a protein that binds to the hormone estrogen. Cancer cells that are estrogen receptor positive may need estrogen to grow.
Estrogen receptor negative status [ER-] 1 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2022 edition of ICD-10-CM Z17. 1 became effective on October 1, 2021. This is the American ICD-10-CM version of Z17.
Listen to pronunciation. (proh-JES-teh-rone reh-SEP-ter PAH-zih-tiv) Describes cells that have a protein that binds to the hormone progesterone. Cancer cells that are progesterone receptor positive may need progesterone to grow.
ICD-10-CM Code for Encounter for follow-up examination after completed treatment for conditions other than malignant neoplasm Z09.
ICD-10-CM Code for Estrogen receptor positive status [ER+] Z17. 0.
Acquired absence of left breast and nipple The 2022 edition of ICD-10-CM Z90. 12 became effective on October 1, 2021.
Hormone Receptor-Positive Breast Cancer About 80% of all breast cancers are “ER-positive.” That means the cancer cells grow in response to the hormone estrogen. About 65% of these are also “PR-positive.” They grow in response to another hormone, progesterone.
If breast cancer cells have estrogen receptors, the cancer is called ER-positive breast cancer. If breast cancer cells have progesterone receptors, the cancer is called PR-positive breast cancer. If the cells do not have either of these 2 receptors, the cancer is called ER/PR-negative.
In general, ER-positive, HER2-negative breast cancers that are low grade, strongly ER and progesterone receptor (PR) positive, with low measures of proliferation have a good prognosis with endocrine treatment alone.
Z09 is an appropriate first-listed code and completely acceptable by payers. The list you are referring to in the guidelines is a list of Z categories and codes that are first only allowed. If the code you chose is not on this list then unless otherwise indicated, it is allowed first or secondary.
Should I code my initial follow-up visit with this patient as a consultation or an office visit? A. You should code this as an office visit because the ER physician does not require your advice or opinion regarding this patient. In addition, patient-initiated appointments do not qualify as consultations.
Z09 ICD 10 codes should be used for diseases or disroder other than malignant neoplasm which has been completed treatment.
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?
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.