# Z code sequencing



## harleymantampa (Jan 29, 2016)

in the use of z codes, I do understand there are some that are first position, and it certainly depends on the documentation. in ICD-9, V codes, unless in first position, went after regular codes, and before E codes, in my experience and understanding. So, I am trying to find a definitive answer, for sequencing of the z codes that are NOT in first position. Z codes such as trach status, vent dependent, etc... I'll make up a simple but real example:

Dr. Dx list. (note this is inpatient professional and the RFV was the respiratory failure

1. Acute Respiratory failure with hypoxia
2. status tracheostomy
3. Gastritis

Would this be sequenced as: J96.01, Z93.0, K29.70....OR....J96.01, K29.70, Z93.0


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## CodingKing (Jan 29, 2016)

Since Z codes are the V code replacement I think they should go last in this example. Here is what the ICD-10 guidelines say about the Z status codes:




			
				2016 ICD-1-CM Guideline I.C.21.c.3 said:
			
		

> *Status*
> 
> Status codes indicate that a patient is either a carrier of a disease or has the sequelae or residual of a past disease or condition. This includes such things as the presence of prosthetic or mechanical devices resulting from past treatment. A status code is informative, because the status may affect the course of treatment and its outcome. A status code is distinct from a history code. The history code indicates that the patient no longer has the condition.
> 
> ...


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