Wiki new to Path question on Icd10 Z codes

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deflepchic

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I haven't coded path since ICD10 was implemented. I don't have a ICD10 Lab book.
Question: When coding and billing for any drug test for pain management is there a guideline that you have to have an encounter code or Z code billed?
To add to that is there any guideline to any other ICD10 code that has to be billed with your regular diag code?
 
You will need an ICD-10 CM code, which one will depend on the reason for the test. If this is the drug screen needed prior to starting treatment then you use a Z code for screening first listed, if this is a test to determine patient compliance with prescribed drug therapy you use drug monitoring (Z51.81) first and the Z79 for the drug secondary.
 
Ok so a Z code for an encounter as in an office visit isn't a must to bill?
The Z code your speaking of.... has to be placed as first and PT diag second? It seems the system here has switches any Z code to the second position.
 
Z codes are allowable first listed and some are required to be first listed. Drug monitoring should be coded with the Z51.81 first and the Z79.- section needs to specify the drug being monitored. In the case of screening there would be no other code to select as first over the Z code for screening.
 
Thanks so much, we have been having issues with a doc's office stating she had no other diag codes but Z13.9 encounter for screening, so what I am understanding that code can stand only for billing and payment? Just making sure before I give out the wrong info.
 
The guidelines specify that screening Z codes are to be use only for the encounter where the screening procedure is performed. The physician office ordered it, the Lab performed it.
 
Well we are the lab that receives UAs. We get the order from the office with attached urine cup. We (the Lab) bills out so I would say that falls under the guideline, I hope! :)
 
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