Wiki Billing for Lynch Syndrome

[alaynagast]

Does anybody know what to do in regards to billing an EGD for Lynch Syndrome?
Z15.09 (General susceptibility to other malignant neoplasm) has been getting denied by all insurances, but that's the primary reason for getting the EGD done.

 

[natcat74]

I am having the same issue, there is no other code available so i had to look through the patient chart and find another diagnosis to use for primary, then use the Z code. It will not be accepted as a primary diagnosis, even if it is the reason for the visit.

 

[trarut]

Z15.09 can't be used as a primary diagnosis. The patient typically will have a known cancer (current or historical) or a family history of cancer, most likely a colorectal or GI cancer in the case of Lynch Syndrome but there are several cancers that are linked to Lynch Syndrome. The NIH website has some good information about it at https://ghr.nlm.nih.gov/condition/lynch-syndrome#.