FACTORS INFLUENCING HEALTH STATUS AND CONTACT

WITH HEALTH SERVICES

INTRODUCTION• Z codes are used as primary codes or secondary codes

• USE OF Z CODES IN ANY HEALTHCARE SETTING

• Z codes are for use in any healthcare setting.Z codes

may be used as either a first-listed or secondary code,

depending on the circumstances of the encounter.

certain z codes may only be used as first listed or

primary code.

• Z codes indicate reason for an encounter.

• These are not procedure codes.A corresponding

procedure code must accompany a Z code to describe

any procedure performed.

• Use codes from category z20 and z27 for patients who

have been exposed to the disease but who have no

signs and symptoms of the disease. you can use them

as a primary codes for testing encounters or as

secondary codes to supply information about risk.

• Use z23 as a secondary code when the patient has the

inoculation as part of a preventive healthcare visit.

Status codes • A status code offers information about the patient that

may affect treatment,such as presence of a prosthetic

don’t confuse status codes with history codes, which you

use when the patient does not have the condition

anymore.

• When a code description contains status code

information don’t report status code separately

• Drug use; do not use codes from category z79 for

patients addicted to drugs or in

detoxification/maintainence programmes.use drug

dependence code instead.

• Genetic susceptibility assign codes from category z15

only as a secondary code and if the patient has a gene

that increases the patient risk for that disease.

• The z code section includes codes for both personal

history and family history

• Personal history codes typically apply to conditions the

patient used to have that have the potential to occur

again.family history codes represent conditions found in

the patients family suggesting the patient may be at

higher risk for the disease.

• Use the screening z codes for tests on patients with no

signs or symptoms of the disease being tested for. if a

patient has a sign or symptom then the test is diagnostic

and a screening code is not appropriate.use the sign or

symptom code for the test encounter instead.

• A code categories include the following

1. Z11-encounter for screening for infectious and parasitic

diseases

2. Z12-encounter for screening for malignant neoplasms

3. Z13-encounter for screening for other diseases and

disorders.except z13.9 encounter for screening

unspecified

4. Z36-encounter for antenatal screening for mother

• Use observation codes only as the primary diagnosis

code. other codes may be added only if they are

unrelated to the reason for observation.

• Code Z21 on a medical record indicates that a patient is

HIV positive and developed AIDS.

• A code from category z22 on a medical record indicates

that the person is capable of transmitting the infection of

an organism and is showing symptoms of that disease

• Code z33.1 pregnant state, incidental should always be

assigned as secondary/additional diagnosis.

• A code from z 79 category may be assigned if a patient

is receiving a medication for an extended period as a

prophylactic measure

• Personal history z codes explain a patients past medical

condition that no longer exists and is not receiving any

treatment and that has no potential for recurrence.

• Family history z codes may be used with screening

codes and personal history z codes with follow-up codes.

• History z codes are used on any medical record

regardless of reason for visit

• Testing a person to rule out or confirm a suspected

condition because the patient has some signs or

symptoms is considered as screening examination and

the visit should be coded with a code for screening

• A screening code is not necessary if the screening is

inherent to a routine examination

• If a condition is confirmed during screening the z code

for screening should not be coded instead only the

confirmed diagnosis should be coded

• Observation codes are to be used as additional

diagnosis always

• Status z codes may be used with aftercare z codes

• A status z code should not be used along with a z code

for aftercare if the aftercare code indicates the type of

status

• A follow up z code indicates that visit is for ongoing care

of a healing condition or its sequelae.

• Z code for follow up examination after surgery should be

coded with history code for the condition treated and

follow up code should be sequenced first followed by the

history code.

• If a condition treated is found to have recurred on a

follow up visit then code only for the recurred condition

• Autologus organ donation conditions may be coded with

a code from category z52

• Counseling z codes are not reported with a diagnosis

code when the counseling component of care is

considered integral to standard treatment

• Codes from z37 category should always assign as

secondary codes

• Codes from z34 category are always used as primary

codes

• A code from category z40.0 encounter for prophylactic

surgery for risk factors related to neoplasms may be

assigned for the removal of ovaries for the treatment of

uterine cancer.

LIST OF SECTIONS• Z00-Z13 Persons encountering health services for

examinations

• Z14-Z15 Genetic carrier and genetic susceptibility to

disease

• Z16-Z16 Resistance to antimicrobial drugs

• Z17-Z17 Estrogen receptor status

• Z18-Z18 Retained foreign body fragments

• Z19-Z19 Hormone sensitivity malignancy status

• Z20-Z29 Persons with potential health hazards related

to communicable diseases

• Z30-Z39 Persons encountering health services in

circumstances related to reproduction

• Z40-Z53 Encounters for other specific health care

• Z55-Z65 Persons with potential health hazards related

to socioeconomic and psychosocial circumstances

• Z66-Z66 Do not resuscitate status

• Z67-Z67 Blood type

• Z68-Z68 Body mass index (BMI)

• Z69-Z76 Persons encountering health services in other

circumstances

• Z77-Z99 Persons with potential health hazards related

to family and personal history and certain conditions

influencing health status

examples• Ex; 45-year old male presented for general examination.

O/E physician noticed pedal edema and advised further

workup

• Ans;z00.01,R60.0

• Ex; A patient is referred to the radiology department for a

chest x-ray as part of a routine physical examination

noted decreased lung sounds on examination

• Ans;z00.01

• Ex;well-child visit the clinician notes enlarged lymph

nodes.code the exam with abnormal findings and in

addition add the code for enlarged cervical lymph nodes

• Ans;Z00.121,R59.0

• EX;Encounter for examination of eyes and vision without

abnormal findings

• Ans;Z01.00

• Ex; Encounter for examination of eyes and vision with

abnormal findings

• Ans;Z01.01

• Resistance to antimicrobial drugs-Z16

• Code first the infection

• MRSA code from chapter-1 resistance to

antibiotics,antifungals,antivirals etc.assign the code from

category Z16.

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