AHA Coding Clinic® for ICD-10-CM and ICD-10-PCS - 2017 Issue 4; Ask the Editor

Pediatric vs. Adult Diagnosis Code

Is there any official guidance as to when a pediatric versus an adult diagnosis code may be used? We are getting many rejections/denials, as there appear to be different ages for edits. Within my ICD-10-CM book, code Z00.121, Encounter for routine child health examination with abnormal findings, has a notation for “pediatric diagnosis Age 0-17,” while code Z00.00, Encounter for general adult medical examination without abnormal findings, shows “Age - Adult Diagnosis Age 15-124).” For example, if a 16-year-old presents for a routine health exam without abnormal findings, which diagnosis code (adult or pediatric) should be reported and why? There are code edits with overlapping age ranges and it is not clear which code is appropriate for reporting purposes. ...

To read the full article, sign in and subscribe to AHA Coding Clinic® for ICD-10-CM and ICD-10-PCS .


  • The official AHA publication for ICD-10-CM and ICD-10-PCS coding guidelines and advice
  • Current newsletters added each quarter
  • Full Archives - over 3100 articles
  • ALL years/issues back to 1984 organized by year and issue
  • Includes ICD-10-CM/PCS Articles since 2013
  • Fully searchable through Find-A-Code's Comprehensive Search
  • Codes mentioned in articles are linked to Code Information pages
  • Code Information pages link back to related articles
  • View all the articles associated with any code, right from the code page!
Access to this feature is available in the following products:
  • AHA's Coding Clinic® - ICD-10-CM/PCS +Archives

free demo
request yours today
pricing
for any budget
sign IN
welcome back!

Thank you for choosing Find-A-Code, please Sign In to remove ads.