nc_coder
Expert
I just noticed the routine exam code Z00.00 had an age limit of 15-124, but Z00.129 has age limit of 0-17. These codes overlap for 15-17 year olds. Which would be correct of a routine exam on a 16 year old?
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Wiki I-10 confusion
- Thread starter nc_coder
- Start date
Can I ask where you are finding that information? I see that Z00.110-Z00.11 have specific age groups. Z00.121-Z00.129 is for a child over 28 days old and Z00.00-Z00.01 indicated adult without age associated with it. I have looked in the Official Guidelines and do not find reference to the ages you mention.
nc_coder
Expert
I should have looked into that a little more before I posted that question. The age restrictions are listed on EncoderPro, but I haven't seen it anywhere else either.
mhanson1
Networker
Those are Medicare edits (age conflict), and can be found here:
http://www.cms.gov/Medicare/Coding/ICD10/downloads/ICD10_mce27_user_manual.pdf
Michelle
http://www.cms.gov/Medicare/Coding/ICD10/downloads/ICD10_mce27_user_manual.pdf
Michelle
Brenda,
NC_coder asked specifically about the Z00.00 and the Z00.129. The Age and Sex edit symbols on the codes (in this case an 'A' for Z00.00 and a 'P' for the Z00.129) in the 2013 ICD-10 CM draft book by Optum show the Z00.00 as 15-124 and the Z00.129 as age limit of 0-17. So there is an overlap and if the CPT code was a 99384 or a 99394 (with age parameters of 12-17) either CM code would be correct. But those age parameters are defined in the coding book.
NC_coder asked specifically about the Z00.00 and the Z00.129. The Age and Sex edit symbols on the codes (in this case an 'A' for Z00.00 and a 'P' for the Z00.129) in the 2013 ICD-10 CM draft book by Optum show the Z00.00 as 15-124 and the Z00.129 as age limit of 0-17. So there is an overlap and if the CPT code was a 99384 or a 99394 (with age parameters of 12-17) either CM code would be correct. But those age parameters are defined in the coding book.
Very good point, there does appear to be an overlap in the age edits.
These are Medicare edits so it will be interesting to see how other carriers interpret the age.
These are Medicare edits so it will be interesting to see how other carriers interpret the age.