Wiki ICD-10 Medicare Coding for Annual Well Woman/High Risk

[Lwalker85]

With ICD-9 a high risk annual well woman exam would be covered yearly if the diagnosis code V15.89 (Other specified personal history presenting hazards to health, other) was on the claim and the patient met the high risk requirements.

I have several Medicare patients who qualify as high risk and do get their annuals on a yearly basis. Now that ICD-10 is in effect, there is no documentation on Medicare's (Palmetto GBA J11) website giving the new equivalent code for high risk.

I recently billed a claim with Z77.9 (Other contact with and [suspected] exposures hazardous to health) in hopes that it would get paid and be recognized as the high risk code. However, the claim has denied. I am now at a dead end in this situation and have held several claims until I can find the correct code Medicare considers as high risk.

Any help or input would be greatly appreciated!

Loren

 

[spap@apprhs.org]

mine denied too, and I even found that dx as being OK per ACOG. I changed to Z91.89 and waiting to see what happens. ACOG had also listed that.

http://www.acog.org/-/media/Departments/Coding/Medicare-Preventive-Services-2015.pdf?la=en

 

[slandstra]

I have also tried billing with Z91.89 and they denied payment for this code as well. Still trying to solve this one.

 

[pcampbell135]

I am having the same problem. Will contact CGS (Ohio) see what they say and post it.