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LuckyLily

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I've posted this question in another section in this forum but have not had a response. My manager instructed me to use
Z51.89 (encounter for other specified aftercare) as primary, followed by additional code, for all of the Occupational Medicine accounts. (Except for injuries which have the A,D,S). for example it would be Z51.89 followed by M54.5 (low back pain) Does this seem correct? I don't know why she would want to use aftercare codes. When would it be appropriate to use the aftercare codes?

If you have any insight, it would be welcomed.
 
I use that code when coding for the Nursing Home client I have. 99308 tends to get denied unless there really is a good reason for the visit. After researching, I decided to try Z51.89 because it best fit the encounter reason like there is management of a condition, or a follow up visit for a fracture that is healing, or not. I do not use it on every visit, just the ones it applies to. It has helped get the claim paid. Of course when I review the MR and the visit clearly is not acute or urgent, then I let the client know.

I hope that helps!
 
Read your guidelines! For rehabilitation it states:
When the purpose for the admission/encounter is rehabilitation, sequence first the code for the condition for which the service is being performed. For example, for an admission/encounter for rehabilitation for right-sided dominant hemiplegia following a cerebrovascular infarction, report code I69.351, Hemiplegia and hemiparesis following cerebral infarction affecting right dominant side, as the first-listed or principal diagnosis.
If the condition for which the rehabilitation service is no longer present, report the appropriate aftercare code as the first-listed or principal diagnosis. For example, if a patient with severe degenerative osteoarthritis of the hip, underwent hip replacement and the current encounter/admission is for rehabilitation, report code Z47.1, Aftercare following joint replacement surgery, as the first-listed or principal diagnosis.

and for aftercare it states:
The aftercare Z codes should also not be used for aftercare for injuries. For aftercare of an injury, assign the acute injury code with the appropriate 7th character (for subsequent encounter).

And for pain management it states:
If the encounter is for pain control or pain management, assign the code from category G89 followed by the code identifying the specific site of pain (e.g., encounter for pain management for acute neck pain from trauma is assigned code G89.11, Acute pain due to trauma, followed by code M54.2, Cervicalgia, to identify the site of pain).

So to fully address your question more information would be required. However if the encounter was aftercare due to a fracture then you would use the fracture code with a subsequent 7th character and not the Z code.
 
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My take away from this is that for Occupational Medicine to use the condition that is established that required the care, such as M54.5 (back pain). Not to use Z51.89 (aftercare) because the physician is still treating the back pain. I will inform my trainer that Z51.89 would be inappropriate to use.

Any other input would be accepted.
 
In general, the Z codes should be last.

Peace
@_*
Sometimes for fracture aftercare, I'll add Z47.89 because of a cast removal. Is that allowable, mitchellde?
 
You will not use aftercare Z codes for trauma injuries. you only need the trauma code with the appropriate 7th character. so for a cast change from a trauma fracture you would use the fracture code with a 7th character for subsequent care, whichever one fits.
 
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