Wiki Appropriate dx z-codes to use with I10 and E11.9 for office visits to avoid denials

[she803]

Good evening all.
Billing department for outpatient hospital E/M visits have been receiving denials due to providers only billing I10 hypertension or E11.9 diabetes, etc.

However, when reviewing medical reports, either providers would document follow up based on these patients' conditions in addition to medications and lab results for the patient conditions.

Can an experienced coder/auditor provide me with the appropriate z-codes and sequence order to use for these cases in order to be reimbursed?


Thank you for your assistance!

 

[kathleeng]

There shouldn't be an issue with billing those DX codes as primary, not unless there is another DX being reported along with those that causes I10 and/or E11.9 to become a cause and effect code. You may also find an issue if you are billing for a specialty and the primary DX is not in relation to that specialty.