Wiki Z code sequence question

[jhargrovejr]

Hello, looking for help from Medicaid payer - per ICD-10 NCCI Manual, a certain list of Z codes (below) must appear in the primary dx position. Most if not all are encounters - question: if a STI (Sexually Transmitted Infection) screening Z code appears on the same line, does it matter which (encounter or screening) position the screening Z code appears in? And is it correct to bill an encounter and a screening Z code at the same time/same day? Thanks.

16) Z Codes That May Only be Principal/First-Listed Diagnosis (pp. 99-100)
The following Z codes/categories may only be reported as the principal/first-listed diagnosis, except when there are multiple encounters on the same day and the medical records for the encounters are combined:
Z00 Encounter for general examination without complaint, suspected or reported diagnosis
Except: Z00.6
Z01 Encounter for other special examination without complaint, suspected or reported diagnosis
Z02 Encounter for administrative examination
Z03 Encounter for medical observation for suspected diseases and conditions ruled out
Z04 Encounter for examination and observation for other reasons
Z33.2 Encounter for elective termination of pregnancy
Z31.81 Encounter for male factor infertility in female patient
Z31.83 Encounter for assisted reproductive fertility procedure cycle
Z31.84 Encounter for fertility preservation procedure
Z34 Encounter for supervision of normal pregnancy – listed in addition to screening in a couple of the examples below
Z39 Encounter for maternal postpartum care and examination
ICD-10-CM Official Guidelines for Coding and Reporting FY 2017 Page 100 of 114

Z38 Liveborn infants according to place of birth and type of delivery
Z42 Encounter for plastic and reconstructive surgery following medical procedure or healed injury
Z51.0 Encounter for antineoplastic radiation therapy
Z51.1- Encounter for antineoplastic chemotherapy and immunotherapy
Z52 Donors of organs and tissues
Except: Z52.9, Donor of unspecified organ or tissue
Z76.1 Encounter for health supervision and care of foundling
Z76.2 Encounter for health supervision and care of other healthy infant and child
Z99.12 Encounter for respirator [ventilator] dependence during power failure

 

[mitchellde]

I am not sure what you question really is. This list comes from the official coding guidelines and applies to all coders and all payers. The Z code for screening is not on this list and therefore it may be first or secondary. It may be correct to bill an encounter and a screening, it really depends on the encounter. the payer may not pay the screening as not all screenings are covered.

 

[jhargrovejr]

Z codes - thank you!

Thanks for your response mitchellde