I work at a wound clinic and a few times now, we have had patients referred to us for one thing or another (say like a pressure ulcer) but upon examination during the initial appointment, there is nothing there. We can't use Z09 for the primary dx because that is for follow up examination after treatment. And my understanding is Z00.0X is for wellness and annual exams. Maybe Z01.89 encounter for other specified special examination? It doesn't feel right using the dx code that was on the referral; like if the referral said a stage 2 pressure ulcer, but the ulcer isnt there anymore...so its not our diagnosis. Suggestions?