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ICD-10 Guide
ICD-10 CodesZ15.81

Z15.81

Genetic susceptibility to multiple endocrine neoplasia [MEN]

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

Code Description

ICD-10 Z15.81 is a billable code used to indicate a diagnosis of genetic susceptibility to multiple endocrine neoplasia [men].

Key Diagnostic Point:

Z15.81 indicates a genetic predisposition to multiple endocrine neoplasia (MEN), a group of disorders characterized by the development of tumors in multiple endocrine glands. This code is crucial for identifying patients who may require enhanced surveillance and preventive measures due to their genetic background. Social determinants of health, such as access to genetic counseling and screening services, significantly influence health outcomes for these patients. Preventive care strategies may include regular screenings for associated tumors, lifestyle modifications, and education about the implications of genetic susceptibility. The use of this code can facilitate appropriate referrals to specialists and ensure that patients receive comprehensive care tailored to their genetic risks.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Requires thorough documentation of family history and genetic testing results.
  • Involves understanding of multiple endocrine neoplasia syndromes and their implications.
  • May necessitate coordination with genetic counselors and specialists.
  • Potential for misclassification if not properly documented.

Audit Risk Factors

  • Inadequate documentation of genetic testing or family history.
  • Failure to link Z code with appropriate preventive services.
  • Misuse of the code without confirmed genetic susceptibility.
  • 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 known genetic susceptibility, discussions about lifestyle modifications, and referrals for screenings.

Billing Considerations

Consider social determinants such as access to care, patient education, and support systems.

Public Health

Documentation Requirements

Collect data on population-level genetic predisposition and outcomes, track screening rates.

Common Clinical Scenarios

Epidemiological studies on MEN prevalence, community education programs about genetic risks.

Billing Considerations

Focus on health equity and access to genetic counseling and preventive services.

Coding Guidelines

Inclusion Criteria

Use Z15.81 When
  • Z codes are used to indicate factors influencing health status and contact with health services
  • 81 should be used when there is confirmed genetic susceptibility to MEN, and it should be sequenced appropriately with any related conditions or preventive services
  • Payer requirements may vary, so it is essential to verify coverage for genetic counseling and screenings

Exclusion Criteria

Do NOT use Z15.81 When
No specific exclusions found.

Related CPT Codes

81292CPT Code

Genetic testing for MEN1 gene

Clinical Scenario

Used when a patient is being evaluated for MEN.

Documentation Requirements

Document the reason for testing and results.

Specialty Considerations

Primary care providers should coordinate with genetic specialists.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for greater specificity in coding genetic conditions, improving the ability to track and manage patients with genetic susceptibility to MEN.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for greater specificity in coding genetic conditions, improving the ability to track and manage patients with genetic susceptibility to MEN.

Reimbursement & Billing Impact

reimbursement.

Resources

Clinical References

  • •
    National Comprehensive Cancer Network (NCCN) Guidelines for Genetic/Familial High-Risk Assessment

Coding & Billing References

  • •
    National Comprehensive Cancer Network (NCCN) Guidelines for Genetic/Familial High-Risk Assessment

Frequently Asked Questions

When should Z15.81 be used?

Z15.81 should be used when a patient has a confirmed genetic susceptibility to MEN, particularly when planning preventive care and screenings.