Z79.899

[msawyer]

The HPI states she has been on Nexium for GERD for years and the A & P says to continue current treatment. Would you usez79.899 for Nexium? if yes or no please explain why you would or wouldn't

 

[thomas7331]

I would not assign the code just based on what you've said here.

I have never assigned Z79.899 to report simply that a patient is on a medication. I feel it adds no important information, and in some practices it would result in the code being used on almost every patient's visit. I only use this code if the provider has documented something specifically about the long-term use of a medication and how it is affecting the patient's care or treatment plan, for example if the patient's use of the medication is putting them at some kind of risk, or requires some kind of monitoring, or is incompatible with another medication that the provider would normally use to treat a problem - something to that effect.

So in situations where medication use is affecting the provider's decision making, I'll report it to show that it's a factor in the encounter, but I don't use it for every patient who is on a medication. So far, I've never had any issues with an auditor citing me an error for omitting the code.

 

[msawyer]

I would not assign the code just based on what you've said here.

I have never assigned Z79.899 to report simply that a patient is on a medication. I feel it adds no important information, and in some practices it would result in the code being used on almost every patient's visit. I only use this code if the provider has documented something specifically about the long-term use of a medication and how it is affecting the patient's care or treatment plan, for example if the patient's use of the medication is putting them at some kind of risk, or requires some kind of monitoring, or is incompatible with another medication that the provider would normally use to treat a problem - something to that effect.

So in situations where medication use is affecting the provider's decision making, I'll report it to show that it's a factor in the encounter, but I don't use it for every patient who is on a medication. So far, I've never had any issues with an auditor citing me an error for omitting the code.

I've had 3 auditors ( error me on this) say this should be added even though the Guideline clearly indicate "prescribed drug" they say since it includes aspirin and aspirin in over counter medication (I believe aspirin therapy a whole different regiment not just being over counter drug) Also, I work for GI that would mean I would have to use for every patient as most have GERD and on some kind of PPI medications
79 Long-term (current) drug therapy
Codes from this category indicate a patient’s continuous use of a prescribed drug (including such things as aspirin therapy) for the long-term treatment of a condition or for prophylactic use. It is not for use for patients who have addictions to drugs. This subcategory is not for use of medications for detoxification or maintenance programs to prevent withdrawal symptoms (e.g., methadone maintenance for opiate dependence). Assign the appropriate code for the drug use, abuse, or dependence instead.

 

[thomas7331]

I've had 3 auditors ( error me on this) say this should be added even though the Guideline clearly indicate "prescribed drug" they say since it includes aspirin and aspirin in over counter medication (I believe aspirin therapy a whole different regiment not just being over counter drug) Also, I work for GI that would mean I would have to use for every patient as most have GERD and on some kind of PPI medications
79 Long-term (current) drug therapy
Codes from this category indicate a patient’s continuous use of a prescribed drug (including such things as aspirin therapy) for the long-term treatment of a condition or for prophylactic use. It is not for use for patients who have addictions to drugs. This subcategory is not for use of medications for detoxification or maintenance programs to prevent withdrawal symptoms (e.g., methadone maintenance for opiate dependence). Assign the appropriate code for the drug use, abuse, or dependence instead.

Well, I think then that's a discussion you need to have with your auditors and/or your management team. Generally speaking, auditors should be following the same quality guidelines that your organization follows so that coders and auditors are aligned in their understanding of the requirements. If your organization needs or wishes to have this code reported, then the auditors would be correct to cite this as an error. Or perhaps the auditors are aware of some guideline or interpretation regarding this that I haven't encountered, in which case they should share that information with you as part of the audit review.

The purpose of an audit shouldn't just be to find errors and penalize coders, but rather should be a learning tool to identify areas for potential improvements. When there are variances between auditors' and the coders' code choices, this gives your organization the opportunity to review findings and make refinements its internal policies. So if your organization feels that this particular code assignment isn't really necessary, then they should either disregard the auditors advice in this case, or advise the auditors that they don't want this cited as an error going forward.

 

[lgardner]

I would just like to clarify that Z79.899 would not be used for aspirin therapy/use; aspirin therapy use has it's own distinct code, Z79.82.