Wiki Follow up after hernia surgery dx codes

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frankal

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What advice would anyone have for dx codes for a patient that is following up in the office that previously an had abdominal hernia repair? Example: Pt came in today for follow up to her incisional hernia repair that was performed 2 weeks ago. The new 2023 abdominal hernia repair codes have 000 global period. I am charging an E/M code for this visit. Would I use dx codes Z09, Z98.890 and K43.9? Any advice would be great!!
 
Ok, so I informed my provider with the response I received to just use Z09 and Z98.890. He is questioning this because he believes that there will not be any reimbursement for the E/M code since there are only Z codes listed and being used for the primary diagnosis. He thinks that K43.2 (incisional hernia) should be listed first, followed by the Z codes. Can somebody explain to me what dx codes they would use when coding for a post op follow up to an incisional hernia repair when there is no global package for the repair to get paid?
 
frankal said:
Ok, so I informed my provider with the response I received to just use Z09 and Z98.890. He is questioning this because he believes that there will not be any reimbursement for the E/M code since there are only Z codes listed and being used for the primary diagnosis. He thinks that K43.2 (incisional hernia) should be listed first, followed by the Z codes. Can somebody explain to me what dx codes they would use when coding for a post op follow up to an incisional hernia repair when there is no global package for the repair to get paid?
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In my opinion, @lgardner gave you the correct coding above and I agree it would be incorrect to code the hernia since it is a condition that no longer exists.

Although you never can completely predict what a payer will do with a claim, there is no reason to believe that the provider will not be paid simply because there are only Z codes listed. Even so, you can't code a claim incorrectly just because you or your provider is concerned about not getting paid.
 
thomas7331 said:
In my opinion, @lgardner gave you the correct coding above and I agree it would be incorrect to code the hernia since it is a condition that no longer exists.

Although you never can completely predict what a payer will do with a claim, there is no reason to believe that the provider will not be paid simply because there are only Z codes listed. Even so, you can't code a claim incorrectly just because you or your provider is concerned about not getting paid.
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I appreciate everything from both of you. I just wanted to clarify more in detail for my providers. For me as a medical coder, these dx codes provide enough information for the visit. Thank you so much!
 
I thought Z09 "... should not be confused with aftercare codes, or injury codes with a 7th character for subsequent encounter, that explain ongoing care of a healing condition or its sequela..." would that mean we would not use Z09 with status post hernia repair icd code?
 
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