History of Cancer-CMS states is unacceptable Primary dx code

[ebredehoeft]

Good Morning,

I just reviewed a list put out by CMS stating the Z08, Z09 are not acceptable for primary dx codes. From the guidelines in the ICD10, book how I understand it, is we are supposed to use Z08-Follow up Examination after completed treatment for malignant neoplasm followed by the code to reflect what kind of neoplasm, so for example Z85.3 Breast Cancer.

When patients are no longer getting treatment for their cancer and they are without evidence of disease recurrence then how else should it be coded? Ideas?

Thanks,
EB

 

[ebredehoeft]

I also see in the ICD 10 book that Z08 and Z09 have Z-1 by them which stands for Zcode as first listed diagnosis. Anyone know why it would likst both unacceptable principal dx per Medicare code edits and then also Z code as first listed ?

 

[mitchellde]

I also see in the ICD 10 book that Z08 and Z09 have Z-1 by them which stands for Zcode as first listed diagnosis. Anyone know why it would likst both unacceptable principal dx per Medicare code edits and then also Z code as first listed ?

It is unacceptable for inpatient admission, for provider office visits it is first listed only allowed.
For a follow up visit for neoplasm, if documented as NED, and no treatment needed or planned you would use the z08 first and the Z code for history of the neoplasm secondary.

 

[ebredehoeft]

Thank you that is what I thought.