z01818,z01812

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Hi everyone I have been coding outpatient lab clearance with z01812 with no dx of the reason for preop we have been changing it z01818 to z01812 please advise if we do this right?
 

thomas7331

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Strictly speaking, the code should be based on the provider's documentation and shouldn't be changed based the fact that you know it's a lab that is being requested. Why are you changing what the provider has sent - are you receiving denials or having a problem with payment using Z01.818?

All that said, though, I suspect it's highly unlikely that the change you're making is going to affect payment, and I don't think payers are going to challenge you on something as simple as this. The difference between the two codes is very minor.
 
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