Wiki Using Z09 for hospital f/u w/ PCP???

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Z09 follow-up after completed treatment

I know the original post is a few years old but I have a question regarding the correct usage of Z09.

Say the patient is seeing the PCP after hospital discharge for resolved chest pain as the main reason for the visit. While the patient is in the office the doctor also addresses the patient's chronic problems.

Would it be appropriate to use Z09 as the first diagnosis with history of chest pain as the secondary, followed by the chronic conditions? Or since the chronic conditions are still active then Z09 should not be used?

Thank you for any guidance on this :)
 
Z09 dx code

Hi
I would not list dx Z09 as the first dx on insurance claim. The dx code Z09 is NOT a first listed diagnosis code. You can check you ICD10 manual year 2017 for this fact ...a page listed in the back of manual. I would list the dx problem then followed by Z codes. Also if follow up for fracture or certain surgery use the appropriate Z dx code.
 
TThivierge said:
Hi
I would not list dx Z09 as the first dx on insurance claim. The dx code Z09 is NOT a first listed diagnosis code. You can check you ICD10 manual year 2017 for this fact ...a page listed in the back of manual. I would list the dx problem then followed by Z codes.
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This is incorrect per coding guidelines - if you have received this instruction from an authoritative source, perhaps you could be more specific than just citing 'a page listed in the back of manual'?

The chapter 21 guidelines specifically say that "Z codes may be used as either a first-listed (principal diagnosis code in the inpatient setting) or secondary code, depending on the circumstances of the encounter. Certain Z codes may only be used as first-listed or principal diagnosis." It would not be correct to code the problem diagnosis first if the condition no longer exists and is not being treated. Z09 would be the correct first-listed code if the follow-up after completed treatment is the primary reason for the encounter.
 
Z09 is an appropriate first-listed code and completely acceptable by payers. The list you are referring to in the guidelines is a list of Z categories and codes that are first only allowed. If the code you chose is not on this list then unless otherwise indicated, it is allowed first or secondary. when using Z09 there would be no current issue to code. You would use a history code.
 
Z09 for all hospital or ED follow up visits

Is it ok to use Z09 for hospital or ED follow up visit other than condition malignant neoplasm? If no, do you know any other code?
 
Jennifer CPC said:
What if the issue isn't resolved and provider called pt to find out how he was doing since being in the ER on the previous night?
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If the issue isn't resolved, you would simply use the diagnosis for the problem. Z09 is specifically for resolved problems after treatment is completed.
 
With my employer, we are instructed to use Z09 for follow ups when the condition(s) are resolved along with the condition code(s) BUT also use Z09 for hospital discharges when the admit date AND discharge date is stated in the documentation.
 
I do not think Z09 is appropriate while the patient is still admitted to the hospital.
Z09 Encounter for follow-up examination after completed treatment for conditions other than malignant neoplasm
Medical surveillance following completed treatment
Use additional code to identify any applicable history of disease code (Z86.-, Z87.-)
Excludes1: aftercare following medical care (Z43-Z49, Z51)
surveillance of contraception (Z30.4-)
surveillance of prosthetic and other medical devices (Z44-Z46)

I personally would not consider the treatment COMPLETED if the patient is still in the hospital. It is generally more applicable to services that are under surveillance for a period of time. Example: patient was diagnosed 2 years ago with skin cancer, and requires 5 years of careful monitoring even though the skin cancer was removed. There are no particular lesions or areas of concern for today's visit. I would code Z09 plus Z85.820 for history of skin cancer.
 
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