Wiki Z00.00 confusion

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jhendrix08

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Hello! I need some help with Dx code Z00.00 due to a recent denial. Should this Dx code ONLY be used when patient is in for a preventive exam (medicare wellness or annual physical)? Is it correct that this code should never be used if the provider is also listing chronic or acute conditions to the office visit?

What if the provider decides to order screening labs during a regular office visit (not at an annual physical) and the patient doesn't have a diagnosis to associate with those screening labs?

I really appreciate any input! This is a confusing one for me. Thank you!!!;)
 
z00.00 is the diagnosis code for a well/preventive encounter. You may have chronic conditions addressed also and the may be listed on the claim, however when you are linking the diagnosis to the procedure/visit codes like the Z00.00 only to the preventive/wellness code no other pointer should be used. if you have diagnosis on the claim that have no link that is OK. If the provider discovers an abnormality while performing the preventive encounter you may also list the abnormality and link that diagnosis only to an office visit and use the Z00.01 code for the preventive diagnosis.
If the provider performs screenings at the time of an encounter, either preventive or other office visit, then you use a screening Z code and link that code to the screening test provided. If the provider ORDERS screening to be done and it is scheduled for another provider or another time then you do not code for it.
 
Z00.00?

Hello all,

I have a confusion with the Z00.00 Dx code, Our Pediatric office is billing this with the Z00.129 routine child visit without abnormal findings and urinalysis was done on the same date of outpatient visit, my question is, can Z00.00 be billed for lab work for a 10 year old? as the code states "Encounter for adult periodic examination and any associated laboratory and radiologic examinations" and I am not clear whether Z00.129 includes lab work.

Any input on this is really appreciated..

Thanks.
 
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There needs to be a reason for the UA.. such as screening.. use the appropriate screening code. Many payers will not pay for labs using the general exam code.
 
Thanks for your response.

UA was done as part of health screening/ general health Examination. So, would just using Z00.129 be sufficient? cause we are getting denials for using Z00.00 for the lab work...
 
I have a doubt with a claim that I have in front of me. There is only 1 diagnosis billed (Z00.00) but provider billed 99202. Is this allowed, or do they also have to bill a preventive code? TIA for your comments.
 
I work for a FQHC with 15-20 providers and they all incorrectly code Z00.00 as an Office Visit 99202-99215 resulting in tons of denials and a waste of my time and my fellow billers. Does any one know of a good resource or article that I can provide to my providers that explains the difference between a Preventive Visit 99381-99397 and an Office visit and how to properly code Z00.00 encounters?

Also, I have been told that we are not able to bill for New Preventive Visits, even though that is the reason the patient came in and a physical was done. Has anyone heard of this? Is it typical that this is can be just the clinic's policy? Or do insurances, just not payout for this service?
 
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