Misty Posted Mon 06th of June, 2016 15:57:07 PM
I can't find an appropriate ICD10 code for an elevated Gail Model lab to use. Patient has this and also has family history of breast cancer. Can you provide me this diagnosis. Thanks a lot.
SuperCoder Answered Tue 07th of June, 2016 02:53:24 AM
Thanks for your question.
Please note that the Gail Model is a tool to estimate a woman's risk of developing breast cancer during the next 5-year period and up to age 90. So there is no ICD code for this. Physician asks several questions including past medical history of the patient as well as the family. You can report codes for current indications if present as well as history codes as per documentation.
About the Gail Model: The Breast Cancer Risk Assessment Tool is based on a statistical model known as the "Gail model," which is named after Dr. Mitchell Gail, Senior Investigator in the Biostatistics Branch of NCI's Division of Cancer Epidemiology and Genetics. The model uses a woman's own personal medical history, her own reproductive history, and the history of breast cancer among her first-degree relatives (mother, sisters, daughters) to estimate her risk of developing invasive breast cancer over specific periods of time. Data from the Breast Cancer Detection Demonstration Project (BCDDP), which was a joint NCI and American Cancer Society breast cancer screening study that involved 280,000 women aged 35 to 74 years, and from NCI's Surveillance, Epidemiology, and End Results (SEER) Program were used in developing the model. Estimates for African American women were based on data from the Women’s Contraceptive and Reproductive Experiences (CARE) Study and from SEER data. CARE participants included 1,607 women with invasive breast cancer and 1,637 without. Estimates for Asian and Pacific Islander women in the United States were based on data from the Asian American Breast Cancer Study (AABCS) and SEER data. AABCS participants included 597 Asian and Pacific Islander women with invasive breast cancer, and 966 women without breast cancer.
The Gail model has been tested in large populations of white women and has been shown to provide accurate estimates of breast cancer risk. In other words, the model has been "validated" for white women. It has also been tested in data from the Women’s Health Initiative for African American women, and the model performs well, but may underestimate risk in African American women with previous biopsies.The model has been validated for Asian and Pacific Islander women in the WHI and data from SEER. The model needs further validation for Hispanic women and other subgroups. Researchers are conducting additional studies, including studies with minority populations, to gather more data and to test and improve the model.
For more info, please go to the link: http://www.cancer.gov/bcrisktool/about-tool.aspx#gail