I am a new coder and I work mostly edits. My question is, if a patient comes in only to get labs drawn and does not see the physician for an exam that day, is it appropriate to code Z00.00? I've seen multiple coders do this when the patient is only there for lab work and it's hitting an edit in my work queue.
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Wiki Primary Dx Z00.00
- Thread starter AshMarsh
- Start date
When a lab order is completed the provider should be noting a diagnosis or reason for the lab draw at that time. Assuming the Z00.00 would not be appropriate. This may be an issue to take to your providers or management team to ensure that that proper documentation is available not only for coding but for audits as well. Any time a lab, xray, etc it ordered, there should be a dx or reason tied to the order.
I agree; the test should always be tied to a specific injury or illness, not a 'general exam' code. Even if they are screening for something to rule it out, the reason for the test needs to be as specific as possible.
Christinepfeifer
Contributor
There are 10 labs recognized for screening purposes by Medicare. All use specific screening codes. None are payable with Z00.00. If your commercial payers follow Medicare, then you will not receive reimbursement for screening labs with Z00.00.