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ICD-10-CM Coding Guidelines - Factors Influencing Health Status and Contact with Health Services (Chapter 21)
 
 

ICD-10-CM Coding Guidelines - Factors Influencing Health Status and Contact with Health Services (Chapter 21)

 
Chapter 21 in ICD-10-CM is titled "Factors Influencing Health Status and Contact with Health Services." This chapter covers code categories Z00-Z99. Conditions covered in this chapter are those related to routine checkups, risk factors, the presence of prosthetic devices, screenings for diseases, and exposure to an infectious disease.
  • Z00-Z13 Persons Encountering Health Services for Examinations – Codes in this subsection correspond with those in categories V70-V82 in ICD-9-CM. The codes in this category are status codes, which report that the patient has a residual condition from a previous disease or is the carrier of a specific disease.

  • Z20-Z28 Persons with Potential Health Hazards Related to Communicable Diseases - Codes in this subsection correspond with those in categories V08-V09 in ICD-9-CM.

  • Z30-Z39 Persons Encountering Health Services in Circumstances Related to Reproduction - Codes in this subsection correspond with those in categories V20-V29 in ICD-9-CM. Pregnancy Z codes are only assigned for routine prental or postpartum care, and in the absence of any other obstetric codes.

  • Z40-Z53 Encounters for Other Specific Healthcare - Codes in this subsection correspond with those in categories V50-V59 in ICD-9-CM. These codes are first-listed to report the reasons for the encounter, but when listed as secondary codes, they reflect the provision of aftercare.

  • Z55-Z65 Persons with Potential Health Hazards Related to Socioeconomic and Psychosocial Circumstances - Codes in this subsection are scattered throughout ICD-9-CM. These codes report problems related to literacy, education, employment, occupational exposure to risk factors, housing circumstances, social environment, primary support group, and other psychosocial issues.

  • Z69-Z76 Persons Encountering Health Services in Other Circumstances - Codes in this subsection correspond with those in categories V60-V69 in ICD-9-CM. Situation reported by these codes are those for mental health services for the victim of abuse, counseling related to sexual behavior, attitude, and orientation, provider dependency, and other circumstances.

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  • Z79-Z99 Persons with Potential Health Hazards Related to Family and Personal History and Certain Conditions Influencing Health Status - Codes in this subsection correspond with those in categories V10-V19 in ICD-9-CM. Family history codes are reported with categories Z80-Z84, and personal history codes are reported with categories Z85-Z92. Z79 codes are assigned for patients using prescribed medicines.

General Guidelines

  •  If a Z code is assigned to indicate that the patient had a surgery or procedure, then the coder must also assign a procedure code.

  • Various Terms useful in search for codes in this category include: "history of," "aftercare," "status," test," palliative care," "management," "long-term," "follow-up," "counseling," and "encounter for."

  • Codes in categories Z00-Z13 are only for encounters for routine examinations, and they are not to be used for examinations for the diagnosis of a condition or for treatment purposes.

  • Observation Z codes are only used in limited situations, such as when a patient is being observed for a suspected disease or condition that is ruled out, or when there are no symptoms or injury related to the suspected condition.

  • Codes in category Z23 are only used to report a patient who receives a prophylactic examination.

  • The coder should assign Z33.1 only as a secondary code, used to reflect that a patient is pregnant, but that the pregnancy is not the reason for the encounter.

  • Codes from category Z34, Encounter for supervision of normal pregnancy, are always listed first, and never used along with other obstetric codes.

  • Codes in the category for after care (Z51) are assigned during the acute treatment phase when a patient is seen in order to receive radiation therapy for a neoplasm, and also when a patient is seen to receive immunotherapy or chemotherapy.

 
 
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