Wiki Z codes

[robin@tnoculoplastics.com]

I am not a coder, but I have to code for our oculoplastic office. First, let me say that I appreciate all the knowledge that this forum has to offer. Just discovered the Z codes this morning as I have a patient that is in for a follow up for removal of Basal Cell Carcinoma Skin/ Right Lower Eyelid, Inc Canthus (C44.1122) I didn't think that it should be coded with the dx as the cancer was removed. A little search here showed me the Z codes. So, from what I have gleaned I would use the Z08 dx and then another history of code. This is where is am stuck. I have found Z86.008 but not sure if that is appropriate or if I can get some guidance on where to look for the needed dx code. THANKS

 

[sls314]

I am not a coder, but I have to code for our oculoplastic office. First, let me say that I appreciate all the knowledge that this forum has to offer. Just discovered the Z codes this morning as I have a patient that is in for a follow up for removal of Basal Cell Carcinoma Skin/ Right Lower Eyelid, Inc Canthus (C44.1122) I didn't think that it should be coded with the dx as the cancer was removed. A little search here showed me the Z codes. So, from what I have gleaned I would use the Z08 dx and then another history of code. This is where is am stuck. I have found Z86.008 but not sure if that is appropriate or if I can get some guidance on where to look for the needed dx code. THANKS

How long ago was the basal cell carcinoma removed? Is the patient receiving any type of further treatment for the basal cell carcinoma? If there is active treatment (even from another physician), it is still appropriate to use the active diagnosis code for the visit.

When the cancer has been excised, no evidence of disease, AND no further treatment, then the history code is appropriate, and you'd use Z08 for the encounter code.

The correct diagnosis code for personal history of basal cell carcinoma is Z85.828, which is used for conditions classifiable to C44.-

The Z86.008 code you listed in your original post is for personal history of in-situ neoplasm, which would be used for conditions classifiable to D09.-

That's always a good way to confirm whether you've selected the correct history code for a neoplasm - the history codes all list the range for the corresponding active neoplasm code.

 

[robin@tnoculoplastics.com]

Awesome information!!! thank you... he came to us 8/3/2022 and he had 2 months of Erivedge therapy and our doctor could see no evidence of the BBC on 4/20/2023. But, it also looks like he is doing 2 months off/on Erivedge so I am assuming i should code it Z08, Z85.828 until/unless it returns.