Pediatric Coding Alert

Know the correct codes to apply and why.

You know that codes from Chapter 21 (Z00-Z99) of ICD-10 detail factors influencing health status and contact with health services, as the chapter title implies. You also know that general guidelines for using a code from Chapter 21 tell you that “Z codes may be used as either a first-listed (principal diagnosis code in the inpatient setting) or secondary code, depending on the circumstances of the encounter,” and that “a corresponding procedure code must accompany a Z code to describe any procedure performed,” because “Z codes are not procedure codes.”

But how well do you know your way around the Z codes for encounters with your pediatric patients? Here are three questions involving common pediatric scenarios that will help you sharpen your Z coding skills.

Question 1: Your provider counsels a 6-year-old male patient and his mother about adverse changes in the boy’s behavior due to the absence of his father. Elsewhere in the patient’s chart, you see that a social worker has documented that the boy’s father has deployed on military duty. This information is not in your provider’s notes. Can you assign a Z code to this encounter and, if so, which one?

Question 2: Your pediatrician cares for a newborn female at a local hospital from the day of birth to the day of discharge from the same hospital three days later. The newborn was born vaginally, and there were no complications at birth or subsequently. What Z code should you use, and why should you not use Z00.110 (Health examination for newborn under 8 days old) to document an encounter like this?

Question 3: A mother brings her 4-year-old to your pediatrician, saying the child has been acting like he is ill, but she can find nothing wrong. Your pediatrician examines the child and agrees with the mother; the pediatrician records no diagnosis, signs, or symptoms. What two possible Z codes could you use in this scenario, and which would be the most appropriate to use?

Think you know the answers? Click here to know the Answers.