# Z code post op xray



## LANGLEY (Jan 29, 2016)

If a patient comes in for post op and xray performed, can a Z47.89 aftercare code stand alone or is another code required in conjunction with it?


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## mitchellde (Jan 29, 2016)

If this is post op due to injury/trauma, then you do not use Z codes for aftercare.  If it was a non injury related condition, then the Z47.89 can stand alone if no other specific Z code applies.


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## bwoolard (Feb 2, 2016)

I agree.  I have used only Z-codes, when appropriate, and have no issues.


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## AlanPechacek (Feb 6, 2016)

Z Codes are "Reason for Encounter Codes," not Diagnosis Codes.  If used for Orthopedic Aftercare for Non-Traumatic Orthopedic problems, then somewhere there is a M Code for the Orthopedic Disorder being treated, and for which the patient is being seen on follow up and with X-rays.  This should be listed and augmented/supplemented with the most specific Z Code.

Respectfully submitted, Alan Pechacek, M.D.


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## mitchellde (Feb 6, 2016)

There is not necessarily an M code for post op if the condition no longer exists to due being surgically corrected.  You cannot use the pre operative condition for post operative encounters.  That is why the Z codes are indicating postoperative status due to the patient no longer having the problem.  So you would not have a "diagnosis" code for post operative care.  For post op due to joint replacement due to having had osteoarthritis in that joint.  You will not code the osteoarthritis, you. Use the Z code for aftercare following joint replacement and the Z code indicating which joint was replaced.


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## LANGLEY (Feb 9, 2016)

mitchellde said:


> If this is post op due to injury/trauma, then you do not use Z codes for aftercare.  If it was a non injury related condition, then the Z47.89 can stand alone if no other specific Z code applies.



so if the patient is getting their xray status post total knee replacement then the z code is applicable, but if the patient is status post ORIF for a fracture then use proper S code with "routine healing" 7th character?


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## mitchellde (Feb 9, 2016)

Correct. Or delayed healing, non Union or malunion whichever status fits the fracture.


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## Katie_Ellis (Mar 22, 2017)

*non traumatic orthopedic conditions*

We have a payer saying that Z09 and Z47.89 is too generic and we must send in corrected claim. What more specific ICD 10 would you use for bunion/hammertoe surgery or achilles reconstruction with the indication of tendinitis? We do a lot of procedures that are not due to injuries and we are having a difficult time figuring out what to use besides personal hx of other musculoskeletal condition. I see that being denied as too vague as well. I explained to the rep that you cannot code for a condition that has been resolved with surgery but he did not understand that. Any input would be great. TIA


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