# Coding a Drug Screen



## DebbieReed1973 (Feb 3, 2016)

I'm trying to figure out how to code drug screenings now when physician wants to do a drug screen on a patient. do they need to code specifically what drugs they are screening for or can they use something like Behavior Disorder (F91.9)? They are so used to using V58.69 but ICD does not have a cross reference code for this. Any help will be greatly appreciated.


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## Walker22 (Feb 4, 2016)

I'm not sure I understand what you are asking for. Are you asking for the ICD-10 equivalent of V58.69? If so, look at Z79.891 or Z79.899.


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## tbaker36@gmail.com (Feb 17, 2016)

*2016 Drug Screens*

I work at a pain management practice where many of our patients are on Opioids so we do bloodwork and random udm's on them.  We are currently billing them with the F11.20, Z79.891 and Z79.899.  However, "Excludes note states that we shouldn't code both the Z codes together".  My question is can you bill the F11.20 with the Z79.891 or Z79.899 as the Excludes note is confusing.

Thank you for any input you can give.


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## Walker22 (Feb 18, 2016)

If the conditions represented by the F code and both Z codes are all documented, then I see no reason not to code them. I don't see anything in my book that says they can't be billed together, but maybe I'm missing something (?).


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## mitchellde (Feb 18, 2016)

You cannot code the F11.2- codes with the Z79.891 code. You use only the F11.2- code.  You cannot substitute the 79.891 with the Z79.899 to avoid this edit if they are on Methadone for heroin tx.  If they are on Methadone for pain management, the F11.2- is not an appropriate code and you would use only the Z79.891.  Taking methadone for pain management is very different that taking it for heroin addiction.  Pain management therapy is not to be coded as drug dependency


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## kjdallas (Feb 19, 2016)

*Urine Tox*

So, if a Dr is billing for pain management, doing urine tox screens, is it appropriate to use only z79.891> Wouldn't I need a primary code?

Thanks!
K


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## mitchellde (Feb 19, 2016)

If you are ordering the test to check for the drug you have prescribed for the patient then it is therapeutic drug level monitoring so use the Z51.81 first listed.


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## kjdallas (Feb 24, 2016)

So I'm coding a Z51.81, Z79.899 or Z79.891 and the individual patient condition/history/DX. Hope this is correct! I don't currently bill Medicare.

Thanks,
K


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