Aromatase Inhibitor Use Reporting - Z79.811

With the implementation of ICD-10-CM came more codes for reporting the long-term use of drugs. There is now a code to report long-term use (LTU) of aromatase inhibitors.

What is an aromatase inhibitor and what is it used for?

Aromatase inhibitors are used in the treatment of hormone receptor-positive, early, and metastatic breast cancer in postmenopausal women and, sometimes, in men with gynecomastia. They stop the production of estrogen in postmenopausal women by blocking the enzyme aromatase. The aromatase enzyme turns the hormone androgen into small amounts of estrogen in the body. This means there is less estrogen available to stimulate the growth of hormone-receptor-positive breast cancer. Since hormone receptor-positive breast cancers need estrogen and/or progesterone to grow, this drug classification is used to slow or stop the growth of these breast cancers.

There are three, FDA-approved aromatase inhibitors used today for treatment of hormone receptor-positive breast cancers:

• Arimidex/anastrozole
• Aromasin/exemestane
• Femara/letrozole

There are times when premenopausal women may be placed on an aromatase inhibitor. In those cases, the patient would also need to be treated with an ovarian suppression drug.

When reviewing the medical record, if a patient has breast cancer or history of breast cancer, the medications should be checked. If the patient is currently taking one of the drugs listed above, then the code at Z79.811, Long-term use (current) aromatase inhibitors should be assigned.

Authored by Kim Boy, RHIT, CDIP, CCS, CCS-P

References:
ICD-10-CM Alphabetic and Tabular Index
cancer.gov/publications/dictionaries/cancer-terms/def/aromatase-inhibitor
ncbi.nlm.nih.gov/pmc/articles/PMC2228389/
komen.org/BreastCancer/AromataseInhibitors.html
wikipedia.org/wiki/Aromatase_inhibitor

The information contained in this coding advice is valid at the time of posting. Viewers are encouraged to research subsequent official guidance in the areas associated with the topic as they can change rapidly.