99213 with ICD 10 Z codes

lcole7465

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I am new to coding for E/M and still a little unsure. I have a claim the BCBSM denied E/M stating the dx (z134 & z8349) are not covered.

This is why the patient was seen, so I'm not sure what else I would be able to use for a primary dx.
 

thomas7331

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99213 is a 'sick' visit code for evaluation/management of a problem, so there would need to be a chief complaint - some kind of symptom or illness that requires that service. Neither of those ICD-10 codes describe a problem - screening is a preventive service and family history does not provide any specific information about the reason or need for the visit. Can you describe a little more what services were documented here?
 

wynonna

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dx code

The diagnoses are usually listed in the assessment section of Medical Decision Making portion on the provider's note. In the absence of a definitive or final diagnosis, it is correct to code signs and symptoms normally found at top of note under History of Present Illness (HPI) or Chief Complaint. (CC) Signs and symptoms may also be found in Review of Systems, where the provider is asking the patient about symptoms related to the different body/organ systems.
 
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