Pathology/Lab Coding Alert

Learn crosswalk from ICD-9.

Sometimes your pathologist gets a request for HER2/neu immunohistochemistry for a patient before a breast cancer diagnosis is firm. That’s when clinicians typically pull out a “V” code to explain the reason for the test.

Use “Other” not “Unspecified”

Your pathologist might see an order for a HER2/neu test, such as 88360 (Morphometric analysis, tumor immunohistochemistry [e.g., Her-2/neu, estrogen receptor/progesterone receptor], quantitative or semiquantitative, each antibody; manual), for breast tissue before a final diagnosis is established. If that’s the case, you’re likely to see an ordering diagnosis such as V76.19 (Other screening breast examination) to describe the reason for the test. Because the clinician is ordering a specified test, V76.19 is generally a better choice than V76.10 (Breast screening for malignant neoplasms, unspecified) for HER2/neu. 

ICD-10 difference: Once ICD-10 goes into effect on Oct. 1, 2015, you’ll have just one code to consider when physicians order HER2/neu prior to a breast cancer diagnosis. That’s because both V76.19 and V76.10 crosswalk to a single code for ICD-10 — Z12.39 (Encounter for other screening for malignant neoplasm of breast). 

Mammography is different: Both ICD-9 and ICD-10 provide different codes in the same family for a screening mammogram for breast cancer.