Wiki Diagnosis is Z76.89

[encomma-watson]

Good morning, everyone.

I have two nurse Practitioners who sees patients and if the patient shows up, I am receiving charge reviews of CPT codes 99202 and 99203 or 99212 and 99213 but the diagnosis code is Z76.89 (Persons encountering health services in other specified circumstances). The patients are given an appointment just to establish care. I cannot move forward with this code because the patients established care because there is nothing wrong with them. If anyone is using EPIC, you know that the bells and whistles goes off and you have "warning Will Robinson" I have been told to change the code to a Z00.00 because the patient was physically seen, ROS was established, Physical Exam was done but I still get Z76.89. This is driving me crazy. What should I do?

 

[TThivierge]

Hi
I d use dx Z00 as directed but probably not get paid. Have the providers read descriptions of CPT 99202-99203, 99212? Are these new patients dealing with any chronic issues or need a diet plan cause obese or want BP checked or my tummy pain R10 or diarrhea R19 or ETC ? What are they documenting as illness or health risk want checked or suffer with now? You cannot bill for future appointments to establish care. Also any CPT such as 99202-99203 need supporting clinical documentation displaying medical necessity.
Well I hope this data helps you
Lady T

 

[encomma-watson]

Hi
I d use dx Z00 as directed but probably not get paid. Have the providers read descriptions of CPT 99202-99203, 99212? Are these new patients dealing with any chronic issues or need a diet plan cause obese or want BP checked or my tummy pain R10 or diarrhea R19 or ETC ? What are they documenting as illness or health risk want checked or suffer with now? You cannot bill for future appointments to establish care. Also any CPT such as 99202-99203 need supporting clinical documentation displaying medical necessity.
Well I hope this data helps you
. Lady T

That is what another colleague of mine said. Use the dx of Z00.00. These are new patients seeing out Nurse Practitioners. They do not have any chronic issues, no diabetes, hypertension, no obesity. No health risk, nothing. I will let them read what CPT 99202 & 99203 indicates. Thank you for your help Lady T