Implemented integration into Electronic Prescribing System of the diagnostic tests “Checking for the presence of BRCA 1, 2 gene mutations”, in the category “Genetic Tests for Hereditary Cancer”, EOPYY informs doctors and its beneficiaries.
The following applies to the prescription process:
The electronic prescription of the specific tests is done using the following diagnosis codes according to the classification of diseases (ICD10):
C56 – Malignant neoplasms of ovaries.
C50 – Malignant neoplasms of the breast.
Z80 – Family history of malignant neoplasm.
Z80.3 – Family history of malignant breast neoplasm.
Z80.4 – Family history of malignant neoplasm of genital organs.
Z80.8 – Family history of malignant neoplasm of other organs or systems
The comments included in the prescription require the doctor to specify the reason for recommending the test, eg breast cancer diagnosed before the age of 45.
In code Z83 (family history of other specific disorders), the physician must clarify with a comment: “woman with a known BRCA 1, 2 gene mutation in her family”. This comment will state which family member it concerns (sister, mother), without mentioning personal data.
The electronic prescription must be made by writing both codes on the same reference: Testing for the presence of BRCA 1, 2 gene mutations with the NGS method and testing for the presence of BRCA 1, 2 gene mutations with the complementary MLPA method, if the physician does not know in advance if the supplementary MLPA method will also be required.
During the execution and submission of the referral by the contracted provider in the EOPYY information system (eDAPY), the separation will be made (submission of only one code or submission of both codes).
The examination will be performed only once per AMKA beneficiary in the EOPYY information system.
The participation of EOPYY beneficiaries for the BRCA 1,2 (NGS) examination is set at 78.75 euros, compared to the amount of 105 euros corresponding to 15% of the price of the Official Gazette. When the execution of the additional MLPA method is also required, the participation will be increased by 7.5 euros.
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