Wiki When to know to use Z codes

[Mrsrpc]

The example in the CPB training says: "Pt presents for follow up visit after completing treatment for malignant neoplasm. To locate teh Diagnosis code, look in iCD-10-CN alphabetic index for examination/follow up (routing)(Following)/malignant neoplasm to locate Z08." I'm scared, because I would have looked up Neoplasm, Malignant in alphabetic index looking for a DIAGNOSIS code. Encounter seems like it's a procedure code. How do I know when/how to differentiate between what the course says to do and what looks like I should do (but isn't what I should do)? I cannot at all feel confident that I won't make the same mistake bc I don't know the difference.

 

[LisaAlonso23]

The example in the CPB training says: "Pt presents for follow up visit after completing treatment for malignant neoplasm. To locate teh Diagnosis code, look in iCD-10-CN alphabetic index for examination/follow up (routing)(Following)/malignant neoplasm to locate Z08." I'm scared, because I would have looked up Neoplasm, Malignant in alphabetic index looking for a DIAGNOSIS code. Encounter seems like it's a procedure code. How do I know when/how to differentiate between what the course says to do and what looks like I should do (but isn't what I should do)? I cannot at all feel confident that I won't make the same mistake bc I don't know the difference.

I completely understand. You need to simplify your approach to ICD-10 coding.

First, ask yourself why the patient is having the procedure. In this case, it's a follow-up exam.
Look up "exam".

Then, what type of exam it is. Yours is a follow-up for a malignant neoplasm.
Exam>follow-up>malignant neoplasm = Z08

Find Z08 in the tabular, and you'll see an instructional note to use an additional code to identify the personal history of malignant neoplasm. This will be an additional Z code.

I hope this is helpful.