2022 ICD-10-CM Code R97.1

Elevated cancer antigen 125 [CA 125]

Version 2021
No Valid Principal Dx

Valid for Submission

ICD-10:R97.1
Short Description:Elevated cancer antigen 125 [CA 125]
Long Description:Elevated cancer antigen 125 [CA 125]

Code Classification

  • Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00–R99)
    • Abnormal tumor markers (R97)
      • Abnormal tumor markers (R97)

R97.1 is a billable diagnosis code used to specify a medical diagnosis of elevated cancer antigen 125 [ca 125]. The code R97.1 is valid during the fiscal year 2022 from October 01, 2021 through September 30, 2022 for the submission of HIPAA-covered transactions.

According to ICD-10-CM guidelines this code should not to be used as a principal diagnosis code when a related definitive diagnosis has been established.

Index to Diseases and Injuries

The Index to Diseases and Injuries is an alphabetical listing of medical terms, with each term mapped to one or more ICD-10 code(s). The following references for the code R97.1 are found in the index:

Convert R97.1 to ICD-9 Code

Information for Patients


CA-125 Blood Test (Ovarian Cancer)

What is a CA-125 blood test?

This test measures the amount of a protein called CA-125 (cancer antigen 125) in the blood. CA-125 levels are high in many women with ovarian cancer. The ovaries are a pair of female reproductive glands that store ova (eggs) and make female hormones. Ovarian cancer happens when there is uncontrolled cell growth in a woman's ovary. Ovarian cancer is the fifth most common cause of cancer death in women in the U.S.

Because high CA-125 levels can be a sign of other conditions besides ovarian cancer, this test is not used to screen women at low risk for the disease. A CA-125 blood test is most often done on women already diagnosed with ovarian cancer. It can help find out if cancer treatment is working, or if your cancer has come back after you have finished treatment.

Other names: cancer antigen 125, glycoprotein antigen, ovarian cancer antigen, CA-125 tumor marker

What is it used for?

A CA-125 blood test may be used to:

Why do I need a CA-125 blood test?

You may need a CA-125 blood test if you are currently being treated for ovarian cancer. Your health care provider may test you at regular intervals to see if your treatment is working, and after your treatment is finished.

You may also need this test if you have certain risk factors for ovarian cancer. You may be at a higher risk if you:

What happens during a CA-125 blood test?

A health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.

Will I need to do anything to prepare for the test?

You don't need any special preparations for a CA-125 blood test.

Are there any risks to the test?

There is very little risk to having a blood test. You may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.

What do the results mean?

If you are being treated for ovarian cancer, you may be tested several times throughout your treatment. If testing shows your CA-125 levels have gone down, it usually means the cancer is responding to treatment. If your levels go up or stay the same, it may mean the cancer is not responding to treatment.

If you have finished your treatment for ovarian cancer, high CA-125 levels may mean your cancer has come back.

If you are not being treated for ovarian cancer and your results show high CA-125 levels, it can be a sign of cancer. But it may also be a sign of a noncancerous condition, such as:

If you are not being treated for ovarian cancer, and your results show high CA-125 levels, your health care provider will probably order more tests to help make a diagnosis. Talk to your health care provider if you have questions about your results.

If your health care provider thinks you may have ovarian cancer, he or she may refer you to a gynecologic oncologist, a doctor who specializes in treating cancers of the female reproductive system.

Learn more about laboratory tests, reference ranges, and understanding results.

Is there anything else I need to know about a CA-125 blood test?

A test for a tumor marker called HE4 may be done along with a CA-125 blood test. An HE4 test is most often used to monitor women who have been treated for a common type of ovarian cancer called epithelial ovarian cancer. Some studies show that HE4 may be more accurate than CA-125 in predicting whether this type of cancer will come back. 

References

  1. American Cancer Society [Internet]. Atlanta: American Cancer Society Inc.; c2018. Can Ovarian Cancer Be Found Early? [updated 2016 Feb 4; cited 2018 Apr 4]; [about 3 screens]. Available from: https://www.cancer.org/cancer/ovarian-cancer/detection-diagnosis-staging/detection.html
  2. American Cancer Society [Internet]. Atlanta: American Cancer Society Inc.; c2018. Key Statistics for Ovarian Cancer [updated 2018 Jan 5; cited 2018 Apr 4]; [about 4 screens]. Available from: https://www.cancer.org/cancer/ovarian-cancer/about/key-statistics.html
  3. American Cancer Society [Internet]. Atlanta: American Cancer Society Inc.; c2018. What Is Ovarian Cancer? [updated 2016 Feb 4; cited 2018 Apr 4]; [about 3 screens]. Available from: https://www.cancer.org/cancer/ovarian-cancer/about/what-is-ovarian-cancer.html
  4. Cancer.net [Internet]. Alexandra (VA): American Society of Clinical Oncology; 2005–2018. Ovarian, Fallopian Tube, and Peritoneal Cancer: Diagnosis; 2017 Oct [cited 2018 Apr 4]; [about 3 screens]. Available from: https://www.cancer.net/cancer-types/ovarian-fallopian-tube-and-peritoneal-cancer/diagnosis
  5. El Bairi K, Afqir S, Amrani M. Is HE4 Superior over CA-125 in the Follow-up of Patients with Epithelial Ovarian Cancer? Curr Drug Targets [Internet]. 2020 Apr 25 [cited 2020 May 7]; doi: 10.2174/1389450121666200425211732. Available from: https://www.ncbi.nlm.nih.gov/pubmed/32334501
  6. Innao P, Pothisuwan M, Pengsa P. Does Human Epididymis Protein 4 (HE4) Have a Role in Prediction of Recurrent Epithelial Ovarian Cancer. Asian Pac J Cancer Prev  [Internet]. 2016 [cited 2020 May 7];17(9):4483-86. Available from: https://www.ncbi.nlm.nih.gov/pubmed/27797265
  7. Lab Tests Online [Internet]. Washington D.C: American Association for Clinical Chemistry; c2001–2018. CA 125 [updated 2018 Apr 4; cited 2018 Apr 4]; [about 2 screens]. Available from: https://labtestsonline.org/tests/ca-125
  8. Lab Tests Online [Internet]. Washington D.C.: American Association for Clinical Chemistry; c2001–2020. Human Epididymis Protein 4 (HE4) ; [updated 2020 Apr 20; cited 2020 May 7]; [about 2 screens]. Available from: https://labtestsonline.org/tests/human-epididymis-protein-4-he4
  9. Mayo Clinic [Internet]. Mayo Foundation for Medical Education and Research; c1998–2018. CA 125 test: Overview; 2018 Feb 6 [cited 2018 Apr 4]; [about 3 screens]. Available from: https://www.mayoclinic.org/tests-procedures/ca-125-test/about/pac-20393295
  10. Mayo Clinic: Mayo Medical Laboratories [Internet]. Mayo Foundation for Medical Education and Research; c1995–2018. Test ID: CA 125: Cancer Antigen 125 (CA 125), Serum: Clinical and Interpretive [cited 2018 Apr 4]; [about 4 screens]. Available from: https://www.mayomedicallaboratories.com/test-catalog/Clinical+and+Interpretive/9289
  11. NOCC: National Ovarian Cancer Coalition [Internet] Dallas: National Ovarian Cancer Coalition; How am I Diagnosed with Ovarian Cancer? [cited 2018 Apr 4]; [about 4 screens]. Available from: http://ovarian.org/about-ovarian-cancer/how-am-i-diagnosed
  12. NOCC: National Ovarian Cancer Coalition [Internet] Dallas: National Ovarian Cancer Coalition; What is Ovarian Cancer? [cited 2018 Apr 4]; [about 2 screens]. Available from: http://ovarian.org/about-ovarian-cancer/what-is-ovarian-cancer
  13. National Heart, Lung, and Blood Institute [Internet]. Bethesda (MD): U.S. Department of Health and Human Services; Blood Tests [cited 2018 Apr 4]; [about 3 screens]. Available from: https://www.nhlbi.nih.gov/health-topics/blood-tests
  14. University of Rochester Medical Center [Internet]. Rochester (NY): University of Rochester Medical Center; c2018. Health Encyclopedia: CA 125 [cited 2018 Apr 4]; [about 2 screens]. Available from: https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=167&contentid;=ca_125
  15. UW Health [Internet]. Madison (WI): University of Wisconsin Hospitals and Clinics Authority; c2018. Cancer Antigen 125 (CA-125): Results [updated 2017 May 3; cited 2018 Apr 4]; [about 8 screens]. Available from: https://www.uwhealth.org/health/topic/medicaltest/cancer-antigen-125-ca-125/hw45058.html#hw45085
  16. UW Health [Internet]. Madison (WI): University of Wisconsin Hospitals and Clinics Authority; c2018. Cancer Antigen 125 (CA-125): Test Overview [updated 2017 May 3; cited 2018 Apr 4]; [about 2 screens]. Available from: https://www.uwhealth.org/health/topic/medicaltest/cancer-antigen-125-ca-125/hw45058.html
  17. UW Health [Internet]. Madison (WI): University of Wisconsin Hospitals and Clinics Authority; c2018. Cancer Antigen 125 (CA-125): Why It is Done [updated 2017 May 3; cited 2018 Apr 4]; [about 3 screens]. Available from: https://www.uwhealth.org/health/topic/medicaltest/cancer-antigen-125-ca-125/hw45058.html#hw45065

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Code History

  • FY 2021 - No Change, effective from 10/1/2020 through 9/30/2021
  • FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020
  • FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
  • FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
  • FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
  • FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016 (First year ICD-10-CM implemented into the HIPAA code set)