Wiki Appropriate use of Z79.899 Other long term (current) drug therapy

[reddaway@sbcglobal.net]

I have a timing question re: code Z79.899 Other long term (current) drug therapy and how the word “current” and “long term” would be interpreted. Would it be correct coding to use this code at a psychiatric evaluation encounter if prescriptions were written but put on hold pending review of labs ordered at the same encounter? Technically the patient is not “currently” on “long term” medication at that time but they will begin long term drug therapy after labs are reviewed (most likely before their next appointment). Currently at my facility the procedure is to give Z79.899 as the diagnosis code on the lab order but it is not listed in the diagnosis/problem list in the psychiatric evaluation. We know it should be listed in both places but are unsure if it is appropriate to assign Z79.899 at the time of psychiatric evaluation encounter because of our lab process/timing of actually starting meds.

Should the providers be assigning Z79.899 at the psych evaluation if the scripts are on hold at the time they are assigning codes (? Current)? Does “long term” mean going forward as well as currently on meds for a long time?

 

[trarut]

We use these long-term use codes frequently because we have patients on aromatase inhibitors, anticoagulants and other medications for years at a time. We only assign a code when the patient is actively taking the medication (current use) or if they took have a history of taking a medication, such as an anticoagulant, for several years in the past (long term use). If our provider is planning to start the patient on the medication but it is delayed, no code is assigned.

 

[reddaway@sbcglobal.net]

Thank you.

 

[soccerdoc33]

We use these long-term use codes frequently because we have patients on aromatase inhibitors, anticoagulants and other medications for years at a time. We only assign a code when the patient is actively taking the medication (current use) or if they took have a history of taking a medication, such as an anticoagulant, for several years in the past (long term use). If our provider is planning to start the patient on the medication but it is delayed, no code is assigned.

What's the definition of "several years"? At least 3?

 

[trarut]

Yes, "several" is generally defined as at least three. This is not a set-in-stone rule for us. "Long-term" is not defined in the code description - at least I've never seen it - so how we choose to define it for our practice will be different from how it is defined for yours. As I said, we routinely use medications that patients are on for years at a time. A medication used over 2-3 months may not have the same weight for us in terms of pertinence to current care as one that the patient took for 5 years. However, if the 2-3 month drug WAS pertinent, we would certainly report a Z code for it.