Wiki General labs for visit to establish care

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julieduff

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Scenario: New patient comes in to establish care. She has not been seen by a dr in years nor had lab. Provider orders routine lab with no complaints and no previous dx. Is Z00.00 the correct ICD-10 code for this type of visit? A coworker (not a coder) says it is not a valid code and lab will be denied by insurance (Humana). Thank you!
 
Is the provider ordering the test for screening purposes? There may a diagnosis code in the Z13 range that may apply.
 
Agreed...We are a PCP/Internal medicine office and find that coding labs with the Z00.00 has become an issue; insurance carriers are commonly not accepting this code for labs.
 
julieduff said:
Scenario: New patient comes in to establish care. She has not been seen by a dr in years nor had lab. Provider orders routine lab with no complaints and no previous dx. Is Z00.00 the correct ICD-10 code for this type of visit? A coworker (not a coder) says it is not a valid code and lab will be denied by insurance (Humana). Thank you!
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If the provider is ordering labs they are doing so for a reason. Such reasons may be screening for lipoid disorders (Z13.220), other endocrine disorders (Z13.29), diabetes (Z13.1). You should assign these based on what was ordered and can use another code for person encountering health services in other specified circumstances, ie to establish care (Z76.89).
 
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