by Christine Woolstenhulme, QMC QCC CMCS CPC CMRS
Nov 30th, 2015 - Reviewed/Updated Aug 8th
Z-codes are used for the reason of the encounter instead of the V codes, they are found in Chapter 21: Factors influencing health status and contact with health services (Z00-Z99). A corresponding procedure must accompany a Z code if a procedure is performed.
Review the Official ICD-10-CM Coding & Reporting Guidelines Section 1.C.21 which includes specific information on which Z codes may be considered primary. For example, it explains that certain screening codes are considered primary when they are the main reason for the patient encounter.
- The chapter specific guidelines provide additional information about the use of Z codes for specified encounters.
- Be careful about using a Z code as the primary diagnosis listed on a claim. Check the code in FindACode to identify situations where it says to code first another condition.
a. Use of Z codes in any healthcare setting Z codes are for use in any healthcare setting. Z codes may be used as either a first-listed (principal diagnosis code in the inpatient setting) or secondary code, depending on the circumstances of the encounter. Certain Z codes may only be used as first-listed or principal diagnosis.
b. Z Codes indicate a reason for an encounter Z code are not procedure codes. A corresponding procedure code must accompany a Z code to describe any procedure performed. c. Categories of Z Codes 1) Contact/Exposure Category Z20 indicates contact with, and suspected exposure to, communicable diseases. These codes are for patients who do not show any sign or symptom of a disease but are suspected to have been exposed to it by close personal contact with an infected individual or are in an area where a disease is an epidemic. Category Z77, Other contacts with and (suspected) exposures hazardous to health, indicates contact with and suspected exposures hazardous to health.
References/Resources
About Christine Woolstenhulme, QMC QCC CMCS CPC CMRS
Christine Woolstenhulme, CPC, QCC, CMCS, CMRS, is a Certified coder and Medical Biller currently employed with Find-A-Code. Bringing over 30 years of insight, business knowledge, and innovation to the healthcare industry. Establishing a successful Medical Billing Company from 1994 to 2015, during this time, Christine has had the opportunity to learn all aspects of revenue cycle management while working with independent practitioners and in clinic settings. Christine was a VAR for AltaPoint EHR software sales, along with management positions and medical practice consulting. Understanding the complete patient engagement cycle and developing efficient processes to coordinate teams ensuring best practice standards in healthcare. Working with payers on coding and interpreting ACA policies according to state benchmarks and insurance filings and implementing company procedures and policies to coordinate teams and payer benefits.