Spinal fusion M43.20 vs Z98.1

tag60

Guru
Messages
150
Best answers
0
Can anyone tell me the difference between using M43.20 and Z98.1 for the scenario below?

Pt has a history of spinal fusion with residual nerve impairment and requires self-catheterization. She also gets frequent UTIs. Provider orders cath supplies.

Is M43.20 the more appropriate code because it is being actively treated/managed?

Thanks in advance!
 

ancoleman22

Networker
Messages
62
Best answers
0
I believe the difference in this scenario is was the history of spinal fusion a surgical procedure or an actually diagnosis? If the spinal fusion was done during surgery then use the Z98.1 code. If the patient has a natural fusion of the spine or (ankylosing spondylitis) which causes the spine to fuse then use the M43.20 code.

Hopes this helps!
 
Top