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September 2004 · Vol. 16, No. 9

REIMBURSEMENT ADVISER

How to make note of a BRCA mutation

MELANIE  WITT,  RN, CPC, MA

Ms. Witt, former program manager in the Department of Coding and Nomenclature at the American College of Obstetricians and Gynecologists, is an independent coding and documentation consultant. Reimbursement Adviser reflects the most commonly accepted interpretations of CPT-4 and ICD-9-CM coding. When in doubt on a coding or billing matter, check with your individual payer.

Q

I have a patient with a BRCA mutation that places her at high risk for breast and ovarian cancer. Which diagnosis code should I use?

A

If you are removing the organ, use V50.42 (prophylactic ovary removal) or V50.49 (other prophylactic organ removal) as the primary diagnosis.

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