New Diagnosis Proposal Wins Adoption

New code becomes effective Oct. 1, 2022.

I participated in the development of a diagnosis proposal on PTEN Hamartoma Tumor Syndrome for the Coordination and Maintenance Committee Meeting for the PTEN Research Foundation beginning October 2020.

The topic was presented at the September 2021 Coordination and Maintenance Committee meeting. PHTS is a disease caused by an alteration in the PTEN gene. Such an alternation, which may be inherited from the mother or father or occur spontaneously during embryonic development, can affect multiple organs and result in a variety of symptoms. These include macrocephaly (enlarged head circumference), learning difficulties, autism spectrum disorder, vascular anomalies, gastrointestinal polyps (growths in the gut), and hamartomas (benign lesions of the skin and other tissues). In addition, people with PHTS have a significantly increased risk of developing cancer of the breast, thyroid and endometrial (lining of the womb) cancer.

The diagnosis code Q85.81 has been approved by the Coordination and Maintenance Committee and will be effective October 1, 2022. In the process of the code development, the description of this code was truncated to PTEN Tumor Syndrome (PHTS). The PTEN Research Foundation has been working with the Center for Disease Control and Prevention (CDC) in correcting the administrative error. It is important for you to be aware that the correct description appears as an inclusive term under the diagnosis code.  It is hoped that the correction to the title will be completed for the April 1, 2023 ICD-10-CM code release.

Please note that a proposal has been written to correct the classification of PTEN Hamartoma Tumor Syndrome in ICD-11. The information is available on the World Health Organization website.

On another note, flu season is approaching. Seasonal flu vaccines protect against influenza viruses that are predicted to be the most common for the season. The quadrivalent vaccines protect against four different viruses: influenza A (H1N1), influenza A (H3N2), and two influenza B viruses. The three flu vaccines recommended for the 2022/2023 flu season for age 65 and over are Fluzone High-Dose Quadrivalent, Flublok Quadrivalent Recombinant, and Fluad Quadrivalent.

It is recommended to get the flu vaccine in September or October. Patients who get immunized are assigned ICD-10-CM code Z23 (Encounter for Immunization). The CDC has also published guidance that the flu shot, and COVID-19 vaccine may be administered at the same time. 

Resources:

https://www.cms.gov/medicare/icd-10/2023-icd-10-cm

Key Facts About Seasonal Flu Vaccine | CDC