ICD 10 codes has increased lot of complication for medical coders. Since, ICD 10 is very different from ICD 9, the use of these codes has created lot of problem. Still there are lot of ICD 10 coding errors done by medical coders. Most of the errors are happening in coding Z codes, due to increase in number and specificity of ICD 10 codes. Z codes are used in place of V codes in ICD 9.
Also, the sequencing of Z codes is a big issue for coders. There are specific Z codes which are and must be assigned as primary or principal diagnosis only. Similarly, there is list of Z codes which should be used as secondary diagnosis. Medical coders should follow the ICD 10 coding guidelines for coding each Z code.
For each chapter, there is number of Z codes now. For example, if we take pregnancy chapter, for each trimester and weeks of gestation (Z3A) their is separate specific Z code. Similarly for Neoplasm chapter there are specific ICD 10 codes. Today, we will learn about the Z codes related to neoplasm conditions.
Z codes for Neoplasm Chapter
There are many Z codes used in Neoplasm chapter. There are a list of encounter, screening, followup, history ICD 10 codes related to neoplasm. As I said before, do read the ICD 10 coding guidelines before using the Z codes. Medical necessity, sequencing of codes and specificity of Z code can lead to incorrect coding. Below are exams related to neoplasm Z codes.
Follow up examinations
Encounter for chemotherapy, immunotherapy, radiation therapy and prophylactic Surgery
Screening exams
History of diseases and neoplasm, personal and family
Status codes for implants, allergy, use of medication.
Genetic susceptibility, hormone, and receptor status with malignant neoplasm
Palliative care
Most of the Z codes are mainly used for coding neoplasms. Hence, we will check more about using Z codes for neoplasm.
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Z codes as primary Diagnosis for Neoplasm
According to ICD-10-CM Official Guidelines for Coding, Z codes can be used either a first-listed or principal diagnosis code or as an additional code, depending on the circumstances of the encounter. The guidelines indicate that some Z codes may be used only as a principal or first-listed diagnosis code. All of the encounter codes for neoplasm needs to assigned as principle or primary diagnosis. For example, the encounter for chemotherapy, immunotherapy, radiation therapy for neoplasm must be reported as primary diagnosis.
Z51.0, Encounter for antineoplastic radiation therapy
Z51.11, Encounter for antineoplastic chemotherapy
Z51.12, Encounter for antineoplastic immunotherapy
Some of the ICD 10 codes related to neoplasm are used as secondary diagnosis, like the personal and family history of neoplasm. To know more about the diagnosis related to neoplasm, you can refer below ICD 10 codes.
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Screening for testing for malignant neoplasm
Z12.11 Encounter for screening for malignant neoplasm of colon
Z12.12 Encounter for screening for malignant neoplasm of rectum
Aftercare for the continue care or recovery phase of a neoplasm.
Z48.3 Aftercare following surgery for neoplasm
Follow-up exam after completed treatment of malignant neoplasm
Z08 Encounter for follow-up examination after completed treatment for malignant neoplasm
History of personal or family history of malignant neoplasm.
Z85.3 Personal history of malignant neoplasm of breast.
Z80.3 Family history of malignant neoplasm of breast.
Other related ICD 10 codes for neoplasm include:
Z14-Z15 – Genetic Carrier and Genetic Susceptibility to Disease
Z17 – Estrogen Receptor Status
Z19 – Hormone Sensitivity Malignancy Status
Finally, do follow all coding guidelines and use these codes very carefully. Do check the medical necessity as well to avoid failed medical necessity errors with CPT codes. Once you get familiar with these Z codes, then it will not a big headache to use them. If you have anything to add in this article, do share your thoughts in comment section.