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Use of Z51.11, E/M visit only

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LBHathaway

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When an active chemotherapy treatment patient sees the physician for a follow up office visit only with the Oncologist (no chemotherapy administered that day,) I was taught to sequence the cancer diagnosis first, and include Z51.11 and/or Z51.12 sequenced as last. I've never had a claim reject but one has recently hit an edit due to this.



Does anyone else include Z51.11 and/or Z51.12 for an E/M visit for date of service that chemotherapy is not being administered?
 
LBHathaway said:
When an active chemotherapy treatment patient sees the physician for a follow up office visit only with the Oncologist (no chemotherapy administered that day,) I was taught to sequence the cancer diagnosis first, and include Z51.11 and/or Z51.12 sequenced as last. I've never had a claim reject but one has recently hit an edit due to this.



Does anyone else include Z51.11 and/or Z51.12 for an E/M visit for date of service that chemotherapy is not being administered?
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Z51 codes are first listed only allowed. This would be why the denial is being issued. If the visit is not for chemo then code only the neoplasm. You would use the Z51 code for the day of treatment as the first listed code followed by the neoplasm code.
 
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