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v1.0.0
ICD-10 Guide
ICD-10 CodesZ15.02

Z15.02

Genetic susceptibility to malignant neoplasm of ovary

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/12/2025

Code Description

ICD-10 Z15.02 is a billable code used to indicate a diagnosis of genetic susceptibility to malignant neoplasm of ovary.

Key Diagnostic Point:

Z15.02 indicates a genetic predisposition to ovarian cancer, often linked to mutations in genes such as BRCA1 and BRCA2. This code is crucial for identifying patients who may benefit from enhanced screening and preventive measures due to their genetic background. Social determinants of health, such as access to genetic counseling, socioeconomic status, and education about cancer risks, significantly influence health outcomes for these patients. Preventive care may include regular screenings, lifestyle modifications, and discussions about prophylactic surgeries. Screening protocols should be tailored to the individual's risk factors, and aftercare may involve ongoing monitoring and support for those with a family history of ovarian cancer. Accurate coding of Z15.02 ensures that healthcare providers can implement appropriate preventive strategies and allocate resources effectively.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Requires understanding of genetic testing and its implications.
  • Involves knowledge of family history and risk assessment.
  • Documentation must reflect the patient's genetic background.
  • May require coordination with genetic counselors and specialists.

Audit Risk Factors

  • Inadequate documentation of genetic testing results.
  • Failure to link Z15.02 with appropriate preventive services.
  • Misuse of the code without confirmed genetic predisposition.
  • Lack of follow-up documentation for preventive care.

Specialty Focus

Medical Specialties

Primary Care

Documentation Requirements

Document family history, genetic testing results, and preventive care plans.

Common Clinical Scenarios

Routine checkups for patients with a family history of ovarian cancer, referrals for genetic counseling.

Billing Considerations

Consider social determinants such as access to care and patient education on genetic risks.

Public Health

Documentation Requirements

Population health data on genetic predisposition and cancer incidence.

Common Clinical Scenarios

Community outreach programs for genetic screening and education.

Billing Considerations

Focus on health disparities and access to genetic counseling services.

Coding Guidelines

Inclusion Criteria

Use Z15.02 When
  • Z codes are used to indicate factors influencing health status and should be sequenced appropriately
  • 02 should be used when there is a confirmed genetic predisposition to ovarian cancer, and it may be sequenced with codes for preventive services or related conditions
  • Payer requirements may vary, so it is essential to verify coverage for genetic testing and preventive measures

Exclusion Criteria

Do NOT use Z15.02 When
No specific exclusions found.

Related CPT Codes

81211CPT Code

BRCA1 and BRCA2 gene analysis

Clinical Scenario

Used for patients with Z15.02 to confirm genetic predisposition.

Documentation Requirements

Document the reason for testing and results.

Specialty Considerations

Primary care providers should coordinate with genetic counselors.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for greater specificity in coding genetic predispositions, enabling better tracking of patients at risk for ovarian cancer and facilitating targeted preventive care.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for greater specificity in coding genetic predispositions, enabling better tracking of patients at risk for ovarian cancer and facilitating targeted preventive care.

Reimbursement & Billing Impact

reimbursement.

Resources

Clinical References

  • •
    National Comprehensive Cancer Network (NCCN) Guidelines

Coding & Billing References

  • •
    National Comprehensive Cancer Network (NCCN) Guidelines

Frequently Asked Questions

What documentation is required to support the use of Z15.02?

Documentation must include the patient's family history of ovarian cancer, results of any genetic testing, and a plan for preventive care. This ensures that the code is used appropriately and supports the need for enhanced screening.