Oncology & Hematology Coding Alert

Answer: There is no timeframe attached to Z08 (Encounter for follow-up examination after completed treatment for malignant neoplasm). Instead, to apply the code correctly, you’ll look to ICD-10-CM guideline I.C.21.c.8, which tells you the code should be used to “explain continuing surveillance following completed treatment of a disease, condition, or injury.” So, the guideline continues, the code implies “the condition has been fully treated and no longer exists.”

In other words, you’ll use Z08 “to explain multiple visits” when the condition has fully ended, the patient is no longer on a treatment plan or medication, and the provider is monitoring the patient to ensure the condition is, or continues to be, in remission.

Expert coding tip: If the conditions for using Z08 are met in the patient’s medical notes, the guideline tells you to use the code “in conjunction with history codes to provide the full picture of the healed condition and its treatment. The follow-up code is sequenced first, followed by the history code.” This is confirmed by the Use additional code instruction accompanying Z08, which tells you to use a code from Z85.- (Personal history of malignant neoplasm) in addition to the follow-up code.

But remember, the guideline also tells you that if a follow-up visit reveals the condition has recurred, “then the diagnosis code for the condition should be assigned in place of the follow-up code.”