Z76.0

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Kenmore, NY
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If a patient comes in to address a cough and also get her prescriptions for her chronic conditions refilled, how do I code this?
Do I use R05 Cough and Z76.0 Encounter for issue of repeat prescription?
Or do I need to code for the chronic conditions as well, even though they're not currently being evaluated?
Or do I only code R05?
 

jsalzer50

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Vancouver, WA
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Just to get my bearings straight, I shall ask myself this question: What makes a cough chronic? And the answer: According to the Mayo Clinic, "A chronic cough is a cough that lasts eight weeks or longer in adults, or four weeks in children." (Mayo Clinic, 2016).

Then I shall ask this question: "Did the patient come in to evaluate a chronic cough or just a regular cough (less than 8 weeks duration)?" When it's said: "also get her prescriptions for her chronic conditions refilled," what are those chronic conditions?

I would code the cough if it was actually assessed and documented by a physician or qualified healthcare professional. I would also code the repeat prescription with the Z-code you have right there. If the chronic condition(s) are documented in the record, then I would code those too.

I remember being taught that if a patient has a chronic and/or lifelong condition (e.g. diabetes), then we code the diabetes every single visit. I can hear the voice of my Professor right now: "If there is an acute and chronic condition, we code the acute condition first, and the chronic condition code second. This is often called: Acute-on-chronic."

Sincerely, Jacob
 
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