Hi all - Just looking for some clarification. I work in primary care, and my providers have recently started selecting their own ICD-10 codes. They are selecting screening codes (eg, Z12.31 for mammo, Z12.11) as diagnoses on their E&M visits when they order these tests to be done at external facilities at a later date. We do not perform them in our office, let alone on the same day. Should I be using these codes on the claim since it was discussed and ordered? I've always defaulted to using a counseling code in these cases. Thanks!
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Wiki Screening codes when test not performed
- Thread starter ca_cpc
- Start date
thomas7331
Guest
You're correct, those codes are used for reporting when the reason for the encounter is to have a screening, not for an encounter when the provider happens to decide to order it. You could use these codes if the provider performed a screening at their encounters, such as a breast exam, for example.
As @thomas7331 stated, you would not bill these screening ICD10s on your provider's E&M service. I will note that screening code does need to be on the order for the lab/radiology facility to get paid. So the provider does need to select it at some point during documentation, it just should not be on the provider's E&M.
Thanks to both of you for the confirmation! I think what's happening is the providers are attaching the appropriate screening code to the order, and then our EHR (new to us as of last week) is automatically pulling order diagnoses into the A&P, which then links them to the E&M code. I'll be sure to pass this info on to my providers so they can remove them on the billing screen. It's always nice to have back-up on these things, so thank you again!
lgardner
Guest
yes.
Our EHR will pick up any dx that were used during the encounter, including screening codes or other dx that are being used for future annual labs, that were added by an MA.
It can be tricky, so just be aware.