Wiki PT/PTT testing prior to surgery

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G
Code: Z01.812

Code Name: ICD-10 Code for Encounter for preprocedural laboratory examination

Block: Persons encountering health services for examinations (Z00-Z13)

Note: Nonspecific abnormal findings disclosed at the time of these examinations are classified to categories R70-R94.

Excludes 1:examinations related to pregnancy and reproduction (Z30-Z36, Z39.-)

Details: Encounter for preprocedural laboratory examination
Blood and urine tests prior to treatment or procedure
Z01

Includes: routine examination of specific system

Excludes1: encounter for examination for administrative purposes (Z02.-)
encounter for examination for suspected conditions, proven not to exist (Z03.-)
encounter for laboratory and radiologic examinations as a component of general medical examinations (Z00.0-)
encounter for laboratory, radiologic and imaging examinations for sign(s) and symptom(s) - code to the sign(s) or symptom(s)

Excludes2: screening examinations (Z11-Z13)

Guidelines: Factors influencing health status and contact with health services (Z00-Z99)

Note: Z codes represent reasons for encounters. A corresponding procedure code must accompany a Z code if a procedure is performed. Categories Z00-Z99 are provided for occasions when circumstances other than a disease, injury or external cause classifiable to categories A00-Y99 are recorded as 'diagnoses' or 'problems'. This can arise in two main ways:
(a) When a person who may or may not be sick encounters the health services for some specific purpose, such as to receive limited care or service for a current condition, to donate an organ or tissue, to receive prophylactic vaccination (immunization), or to discuss a problem which is in itself not a disease or injury.
(b) When some circumstance or problem is present which influences the person's health status but is not in itself a current illness or injury.

For more details on Z01.812, ICD-10 Code for Encounter for preprocedural laboratory examination , visit: https://coder.aapc.com/icd-10-codes/

Karolina

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Hello All:

I need some help clarifying which diagnoses should be coded in order to support the PT and/or PTT testing which is done prior to surgical procedures incl. biopsies. This test would be done prior to the procedure in order to screen the patient for coagulation. Code V72.63 (Pre-procedural laboratory examination) is not on Medicare's list of approved codes (NCDs 190.16 and 190.17). In many cases the patient does not have a prior history of problems with coagulation.
What would be the appropriate diagnosis coding in the following scenario: Patient X is seen for cancer. Dr. A (medical oncologist) sends patient X to Dr. B (surgeon) for a biopsy. Prior to the biopsy several tests are to be performed for surgical clearance, amongst those are the PT and/or PTT. :confused:
Thanks so much for your insight!
 

mitchellde

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you are correct the V72.84 is not a covered dx code for a PT/PTT in the article cited by boozaam:
Testing prior to any medical intervention associated with a risk of bleeding and thrombosis (other than
thrombolytic therapy) will generally be considered medically necessary only where there are signs or symptoms of a bleeding or thrombotic abnormality or a personal history of bleeding, thrombosis or a condition associated with a coagulopathy. Hospital/clinic-specific policies, protocols, etc., in and of themselves, cannot alone justify coverage.

You cannot use a dx code the patient does not have so you will need to evaluate the value of theis test for the physician, if the patient's condition they are having the surgery for justifies performing the test then use that dx code otherwise either do not order the test or let the patient know up front that it is not covered and have them sign an ABN and then bill the patient, or do the test and write the charge off when it returns as non paid due to LCD.
 

vj_tiwari

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Hey :)

What about V58.83 & V58.61..?

I think before surgery, for some diseases patient is on Coumadin/Anticoagulants. So in most of the surgeries 4-5 days before patient requested to stop Coumadin use. So for Current encounter patient is on anticoagulants. So we can use V58.83 & V58.61 along with V72.8* (Preoperative Exam) series code sets.

Hope this helps!!!

VJ
 

mitchellde

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Hey :)

What about V58.83 & V58.61..?

I think before surgery, for some diseases patient is on Coumadin/Anticoagulants. So in most of the surgeries 4-5 days before patient requested to stop Coumadin use. So for Current encounter patient is on anticoagulants. So we can use V58.83 & V58.61 along with V72.8* (Preoperative Exam) series code sets.

Hope this helps!!!

VJ
Yes that would be correct however the original poster stated the patient had no coagulation issues so there would not be a long term anticoagulant on board.
 
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