Wiki ICD-10 Code Z23 Immunizations - prophylactic

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pedscoder

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There is much debate within our practice about the appropriate use of Z23 Encounter for immunizations. Chapter guidelines state this code "indicates that a patient is being seen to receive a prophylactic inoculation against a disease". Also, "Code Z23 may be used as a secondary code if the inoculation is given as a routine part of preventive health care, such a a well-baby visit." When you go to the code itself, there is a further instruction to "Code first any routine childhood examination". Our interpretation is that this means if a immunization is given in the context of a routine well child visit, then the dx linked to the immunization and the administration CPT codes should be the Z00.121 or Z00.129 which are the dxs for routine exam. And Z23 can be used secondary but is optional. AND Z23 would be used when an immunization is given anytime other than in the course of a routine exam. Any input would be greatly appreciated!
 
pedscoder said:
There is much debate within our practice about the appropriate use of Z23 Encounter for immunizations. Chapter guidelines state this code "indicates that a patient is being seen to receive a prophylactic inoculation against a disease". Also, "Code Z23 may be used as a secondary code if the inoculation is given as a routine part of preventive health care, such a a well-baby visit." When you go to the code itself, there is a further instruction to "Code first any routine childhood examination". Our interpretation is that this means if a immunization is given in the context of a routine well child visit, then the dx linked to the immunization and the administration CPT codes should be the Z00.121 or Z00.129 which are the dxs for routine exam. And Z23 can be used secondary but is optional. AND Z23 would be used when an immunization is given anytime other than in the course of a routine exam. Any input would be greatly appreciated!
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it means you would use the Z00.129/ Z00121 fisted listed on the claim in field 21, it does not matter how you link them in field 24 as long as the correct medical necessity goes to the appropriate line item. So you will list dx a. as Z00.121 with dx b as Z23 you will link a to the preventive E&M and b to the immunization and admin codes.
 
Peds Immunizations

I've worked in Peds for some time now and have attended a few seminars this year for ICD10 training specifically to peds billing and I still don't have a straight answer. I've been told by 2 coders/auditors that only billing Z23 for the immunizations is all that is required when billing with a checkup but another /coder auditor refers to the book stating that the WCC code must come first and Z23 second on all immunizations but if only billing immunizations then Z23 is appropriate. I guess its all in who you talk to :)

Good luck!!
 
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