Wiki coding sequence?

[kirstenoviedo@yahoo.com]

Hi everyone, this is a general question... How do you guy sequence your ICD 10 codes? Are you putting Finding first, then symptoms, then history last? I'm just queries. This is how I trained but I just want to make sure I'm doing this right. I also see in the IDC 10 Guidelines it states that Z codes are Principal codes but I always code them last unless it's a Z12.11. Is this correct?
Open discussion, I would love to hear your thoughts!

 

[TThivierge]

Kristen
Ahh Z dx codes some are primary and some are secondary...it list in the ICD10 manual in coding conventions in front of manual. Z12.11 dx only use that first if fecal lab test done & negative results. If patient has polyps or gastro problem/definitive dx code list that first, then last Z12.11
Sequencing.... if main problem or why pt. seeking treatment disease first is listed by provider, put this first dx. Next follow his or her lead in documentation of list of assessments/ dx code also checking or assign meds. Remember to follow the Excludes 1 rule of redundancy or 2 dx code mean same thing. Or if ICD10 regs say add another dx code if required or combination code and try to be as detailed as possible in accord with differ levels of disease listed per provider. At times provider will give symptoms until sure of disease...this maybe listed in assessments. However if symptoms noted but provider give a definitive dx code in list of assessments.
I hope helped you
Lady T

 

[lindam@caricures.com]

I am not a certified biller - just "promoted" to this job. I have been billing Z12.11 as the primary code for a screening colonoscopy when a patient has a history of colon polyps. Isn't that correct? I follow that with personal history of polyps and then the findings. I've been getting paid, but I want to do it correctly

 

[TThivierge]

I am not a certified biller - just "promoted" to this job. I have been billing Z12.11 as the primary code for a screening colonoscopy when a patient has a history of colon polyps. Isn't that correct? I follow that with personal history of polyps and then the findings. I've been getting paid, but I want to do it correctly

Well the provider is checking for disease of gastro area...try these listed digestive ds. below and then dx Z12.11 or dx Z13.811. Look at dx Z12.10-Z12.13 However if provider gives you a has detailed problem or symptom list that as first dx when checking the colon area
Here are some gastro dx codes for colon area....
Digestive DO K92.89
Intestine DO K63.89 or K59.89
Rectum &Anus Dx K62.89
If doing EGD treatment and does not give some, R dx code symptoms can possible use dx K31.89 DO of Stomach or K22.89 DO of Esophagus area and dx Z13.810
I hope helped you a bit more
Lady T

 

[TThivierge]

I am not a certified biller - just "promoted" to this job. I have been billing Z12.11 as the primary code for a screening colonoscopy when a patient has a history of colon polyps. Isn't that correct? I follow that with personal history of polyps and then the findings. I've been getting paid, but I want to do it correctly

Do you understand how to use modifier XS, 53, 52, PT and 33 regarding colonscopies and EGD?

 

[lindam@caricures.com]

Do you understand how to use modifier XS, 53, 52, PT and 33 regarding colonscopies and EGD?

I work for colon/rectal so no EGD's done here. I use modifier 59 when using 45385 and 45380 for different areas of the colon. I use PT for screening turned diagnostic. 53 for incomplete. I've tried using 52 when patient has a poor prep, but it doesn't seem to help when they have it repeated. I don't know about XS and 33 I thought was for facility or lab or something.

 

[TThivierge]

I work for colon/rectal so no EGD's done here. I use modifier 59 when using 45385 and 45380 for different areas of the colon. I use PT for screening turned diagnostic. 53 for incomplete. I've tried using 52 when patient has a poor prep, but it doesn't seem to help when they have it repeated. I don't know about XS and 33 I thought was for facility or lab or something.

Hi Linda
Some payers want XS instead of 59 modifier if polyps in different areas of the colon see Dx D12 as example. 33 modifier is for FIRST time colonoscopy ever in life time for usually patients age 45-75. Other data you have seems correct
Lady T