2025 ICD-10-CM code R97.8
(Active) Effective Date: N/A Revision Date: N/A Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified - Abnormal tumor markers 18 Feed
Presence of abnormal tumor markers not otherwise specified.
Medical necessity for tumor marker testing should be clearly documented.This includes the clinical rationale for ordering the test, its relationship to the patient's symptoms or diagnosis, and how the results will influence treatment decisions.
Clinicians should thoroughly investigate the underlying cause of abnormal tumor markers, using a combination of diagnostic tests and clinical correlation. This may involve consultation with specialists like oncologists or other relevant specialists depending on the suspected primary site.
In simple words: This code indicates unusual levels of substances in your body that can sometimes be associated with cancer.However, these substances can also be elevated due to other reasons, so it does not necessarily mean you have cancer.Your doctor will use this information along with other tests and examinations to determine what's going on.
This code signifies the presence of abnormal levels of tumor markers that are not classified under other specific codes within the ICD-10-CM system. Tumor markers are substances produced by the body in response to cancer or certain benign conditions, and their levels can be measured in blood, urine, or tissue samples.An abnormal level might suggest the presence of cancer, but it is important to note that it doesn't confirm a diagnosis. Other conditions can also elevate tumor markers, so they're often used in conjunction with other diagnostic tools such as biopsies, imaging scans, and physical examinations.
Example 1: A patient with a history of breast cancer has elevated levels of an unspecified tumor marker.Further investigation is required to determine if this indicates recurrence or another condition., During a routine health check-up, a patient's bloodwork reveals an elevated tumor marker.Imaging studies and further tests are ordered to investigate potential underlying causes., A patient presents with vague symptoms such as fatigue and weight loss.Blood tests show abnormal tumor markers. Further evaluation, including biopsies, is conducted to rule out malignancy and explore other potential diagnoses.
Detailed documentation of the specific tumor marker, the numerical value obtained, the testing methodology, and the clinical indication for the test is crucial.Supporting clinical findings, imaging results, and any correlation with other diagnostic tests should also be documented.
** It's important to distinguish this code from other codes for abnormal tumor markers that specify the particular marker (e.g., R97.0 for elevated CA 125). The choice of the most specific code is essential for accurate billing and reporting.
- Payment Status: Active
- Specialties:Oncology, Internal Medicine, Family Medicine, potentially any specialty depending on the context.
- Place of Service:Office, Inpatient Hospital, Outpatient Hospital, Independent Laboratory, and other places of service depending on the context.