tci ED Coding & Reimbursement Alert - 2024 Issue Q3

Reader Questions: Think Beyond Reimbursement for Z Codes and Medical Necessity

Question: Do Z codes really affect reimbursement, or are they mostly designed to pad a patient’s medical record? North Dakota Subscriber Answer: The Z code category of ICD-10-CM is titled “Factors influencing health status and contact with health services (Z00-Z99).” Providers should use Z codes to help provide a comprehensive description of a patient encounter and their current condition — which has the upshot of supplying documentation to meet medical necessity and supporting reimbursement. “Z codes are for use in any healthcare setting. Z codes may be used as either a first-listed (principal diagnosis code...

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