Jul 14, 2026 · 29 min · 12 segments
The secondary review: Corrective Backup? Or a layer of quality assurance? Given that clinical documentation integrity (CDI) invariably has interpretative variability, a secondary review is intended…
Mary McGradyGuest
Penny JeffersonHost
Christine Geiger
Chuck BuckHost
Now's the time for the Talk 10 Tuesday coding report with our good friend, Christine Geiger, and good morning, Chris.
Today is part two of our proposed rule preview, looking at new code additions for syndromes.
First, we're gonna take a look at Li-Fraumeni syndrome with proposed new code QA 1.792. Li-Fraumeni is a rare genetic condition.
Like Lynch syndrome we discussed last week, patients with Li-Fraumeni syndrome have an increased cancer risk According to Cleveland Clinic, those with Li-Fraumeni have a 90% chance of developing at least one type of cancer by the time they reach the age of 60.
Cleveland Clinic also notes that female patients almost always develop breast cancer.
Now, Li-Fraumeni syndrome is due to a mutation in the TP53 gene, and this gene makes a tumor-suppressing protein.
When the mutation occurs, the protein isn't made, and it allows the cells to become cancerous.
The symptoms are gonna be related to the type of cancer that develops.
Li-Fraumeni syndrome is linked to many different types of cancer, but there are five that are most commonly seen.
These five core cancers are sarcomas, breast cancer, brain cancer, adrenocortical carcinoma, and leukemia.
An interesting note, again by Cleveland Clinic when I was researching, is that patients with Li-Fraumeni syndrome are more likely to develop cancers caused by radiation exposure.
Since these patients are developing other cancers, it's important that providers know their diagnosis when they're developing those cancer treatment plans.
This is gonna be a new alphabetic index entry add for Li-Fraumeni syndrome, [clears throat] excuse me, with a proposed new code QA 1.792. Tabular list will add QA 1.7, inherited neoplasm predisposition syndromes involving multiple systems, not elsewhere classified, as we noted last week with Lynch syndrome.
Next, we're gonna take a look at Loeys-Dietz syndrome with a proposed new code of Q87.A.
Sticking with Cleveland Clinic, they note this is a genetic condition that affects the patient's connective tissue, mainly the heart and blood vessels, bones, joints, eyes, and the skin.
Loeys-Dietz is fairly recent, being identified in 2005 by two physicians who the syndrome's named for.
Prior to this, this syndrome may have been diagnosed as Marfan syndrome, because it also is affecting the connective tissue.
Cleveland Clinic also identifies four main sy- features of Loeys-Dietz syndrome.
The first is aneurysms, which can occur in the aorta or other arteries.
Second is arterial tortuosity, most often occurring in neck arteries.
Third is ocular hypertelorism, which is a distinctive feature of Loeys-Dietz.
Now's the time for the Talk 10 Tuesday coding report with our good friend, Christine Geiger, and good morning, Chris.
Today is part two of our proposed rule preview, looking at new code additions for syndromes.
First, we're gonna take a look at Li-Fraumeni syndrome with proposed new code QA 1.792. Li-Fraumeni is a rare genetic condition.
Like Lynch syndrome we discussed last week, patients with Li-Fraumeni syndrome have an increased cancer risk According to Cleveland Clinic, those with Li-Fraumeni have a 90% chance of developing at least one type of cancer by the time they reach the age of 60.
Cleveland Clinic also notes that female patients almost always develop breast cancer.
Now, Li-Fraumeni syndrome is due to a mutation in the TP53 gene, and this gene makes a tumor-suppressing protein.
When the mutation occurs, the protein isn't made, and it allows the cells to become cancerous.
The symptoms are gonna be related to the type of cancer that develops.
Li-Fraumeni syndrome is linked to many different types of cancer, but there are five that are most commonly seen.
These five core cancers are sarcomas, breast cancer, brain cancer, adrenocortical carcinoma, and leukemia.
An interesting note, again by Cleveland Clinic when I was researching, is that patients with Li-Fraumeni syndrome are more likely to develop cancers caused by radiation exposure.
Since these patients are developing other cancers, it's important that providers know their diagnosis when they're developing those cancer treatment plans.
This is gonna be a new alphabetic index entry add for Li-Fraumeni syndrome, [clears throat] excuse me, with a proposed new code QA 1.792. Tabular list will add QA 1.7, inherited neoplasm predisposition syndromes involving multiple systems, not elsewhere classified, as we noted last week with Lynch syndrome.
Next, we're gonna take a look at Loeys-Dietz syndrome with a proposed new code of Q87.A.
Sticking with Cleveland Clinic, they note this is a genetic condition that affects the patient's connective tissue, mainly the heart and blood vessels, bones, joints, eyes, and the skin.
Loeys-Dietz is fairly recent, being identified in 2005 by two physicians who the syndrome's named for.
Prior to this, this syndrome may have been diagnosed as Marfan syndrome, because it also is affecting the connective tissue.
Cleveland Clinic also identifies four main sy- features of Loeys-Dietz syndrome.
The first is aneurysms, which can occur in the aorta or other arteries.
Second is arterial tortuosity, most often occurring in neck arteries.
Third is ocular hypertelorism, which is a distinctive feature of Loeys-Dietz.
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