Wiki Use of Z99.89 for CPAP Use

[dballard2004]

I have a question regarding coding for CPAP or BIPAP use when a patient has a dx of OSA. I have coders who always add code Z99.89 for dependence on other enabling machines and devices to capture the CPAP/BIPAP use. Coding Clinic 2020 1 Q, page 11, has a reference that CPAP use is not specifically classified in ICD-10 as either dependence or status and one should only code CPAP use if the provider specifically documents "dependence" since that is the description of the code Z99.89. I agree with this assessment as (in my opinion) using a CPAP is not necessarily dependence, but the coders are pushing back stating that if the provider documents CPAP use, this would constitute dependence as that is expected treatment for the condition. I respectfully disagree but would like other's insight. Thanks.

 

[OpenClaims]

I have a question regarding coding for CPAP or BIPAP use when a patient has a dx of OSA. I have coders who always add code Z99.89 for dependence on other enabling machines and devices to capture the CPAP/BIPAP use. Coding Clinic 2020 1 Q, page 11, has a reference that CPAP use is not specifically classified in ICD-10 as either dependence or status and one should only code CPAP use if the provider specifically documents "dependence" since that is the description of the code Z99.89. I agree with this assessment as (in my opinion) using a CPAP is not necessarily dependence, but the coders are pushing back stating that if the provider documents CPAP use, this would constitute dependence as that is expected treatment for the condition. I respectfully disagree but would like other's insight. Thanks.

I am unsure of the guidelines on this, but I have always been advised to code Z99.89 if the provider mentions that the patient uses a CPAP for their OSA. However, if the provider documents that the patient has a CPAP but admits in the note that the patient does not use the CPAP, then we are advised to code "Uncomplaince with medical regimen." I can't remember off the top of my head what that code is.

 

[thomas7331]

I have a question regarding coding for CPAP or BIPAP use when a patient has a dx of OSA. I have coders who always add code Z99.89 for dependence on other enabling machines and devices to capture the CPAP/BIPAP use. Coding Clinic 2020 1 Q, page 11, has a reference that CPAP use is not specifically classified in ICD-10 as either dependence or status and one should only code CPAP use if the provider specifically documents "dependence" since that is the description of the code Z99.89. I agree with this assessment as (in my opinion) using a CPAP is not necessarily dependence, but the coders are pushing back stating that if the provider documents CPAP use, this would constitute dependence as that is expected treatment for the condition. I respectfully disagree but would like other's insight. Thanks.

I agree with you, 'use' does not mean 'dependence', and the guidance you've cited here from Coding Clinic backs that up. Use, or long-term use, of CPAP does not index to this code in ICD-10. The coders/auditors in the organizations I've worked with follow that guidance as well that the code is not assigned unless the provider has documented dependence.