Wiki ICD-10 Coding questions

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cmiranda

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Please help! I know it's a lot to ask, but I need answers, I've tried getting them on my own, but need someone's expertise...
1. Does a well exam include vision & screening? Do I use Z01.00 only or what other?

2. For aftercare follow-up (pt. d/c from hosp.), do I use Z09?

3. What code do I use for surgical clearance? Do I code as a well visit with a pre-op diagnosis?

4. With 10, can we bill for nurse visit encounter? If nurse gives immunization, willl I only use Z23?

5. If a procedure billed is linked to 5 or 6 dx. codes, will I have to enter the procedure again on a second line to add the rest of the dx. code units? Since the CM1500 form can only hold 4 digits in the unit section (with zero charge, of course).

6. As a provider once asked me, where is the Pediatric bible for ICD-10-CM & where can I get one? Could this be the AAPC Coding for Pediatrics manual? When will it be available for purchase?

Audit question: With I-10, are auditors looking for something different than I-9? & how can I help my Dr. so we can make every effort possible to not get ding?

I know it's a lot of information but I am currently working with a Pediatrician & this field is completely new to me.
 
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Answers to question 5 & 6

#5.You should be using the new CMS Form 1500 (02-12) that has 12 diagnosis fields. I am surprised because besides work comp and auto claims Every insurance you bill require this form-effective some time last year.


#6. I've attended a few ICD-10 coding seminars and right now you can only purchase a "draft" copy of the ICD 10 book. However, before I purchased I did reach out and ask would there be significant changes and the answer was no. I would suggest purchasing a book to help you with your coding questions.
 
#1 if you do a well check plus vision screening then you will have the Z00.129 plus the Z01.00
#2. Z09 could be used after hospitalization it will just depend on the documentation. To use Z09 for follow up the condition is no longer present and requires no further care. It could also be a follow up code or any of hundreds of other answers depending on the reason for the encounter
#3 you code a preop with the appropriate preop code z code plus the code for the diagnosis requiring surgery with a regular visit level
#4 immunizations are billed with the Z23 and you may not bill with a 99211 use only the immunization codes.
# 5. While the form does allow 12 dx codes in field 21, you are allowed to link only 4 per line item. You cannot link more than 4 so you select the most pertinent of the codes listed for a particular procedure. You cannot bill the same procedure on two lines just to try and link more dx codes.
#6 I have never heard of a "pediatrics bible". A code book is what you need. A 2015 or a 2016 for implementation. No changes or additions were implemented for the 2016 codes from the 2015.
The only thing you are being told to watch for at this time is the over utilization of unspecified codes.
 
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The AAP (American Academy of Pediatrics) has a book, Pediatric ICD-10: A manual for Provider Based Coding" that may be helpful. This would be used as an additional resource to the ICD-10-CM code book. Go to shop.aap.org click on the "shop by topic" in the blue bar at the top, click on coding, and it will be the second book on the list.
 
z00.121 and z00129

Can you please describe the difference between the abnormal and normal physical?
If the physical is abnormal can an office visit be billed on that same day?
 
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