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DX code Z92.21 and Z51.11

Heidi Posted Tue 28th of August, 2018 08:14:10 AM
If we are seeing a patient at the hospital and they happened to have cancer and had just finished treatment, we aren't seeing the patient for a follow up of that treatment, it just so happens they just got done having treatment, and now we may see them for other GI issues, would the appropriate DX code be Z92.21 versus Z51.11? The way I'm reading Z51.11 is we are seeing them and they are going to have it done, or if we were billing the infusion part of it, but if they already had it done, I thought Z92.21 would be the way to go; any advice on this would greatly help for documentation purposes, thanks! :)
SuperCoder Answered Wed 29th of August, 2018 03:34:01 AM

Hi Sherry,


Thank you for your question.


If the patient is seen for other GI issues (use code as per medical record) then the claim would be billable with the diagnosis code for which the patient came and that GI issues (use code as per medical record) would be the primary diagnosis code. You can report personal history or status of treatment code as secondary or tertiary diagnosis code.


Z51.11 (Encounter for antineoplastic chemotherapy) is reported when patient came for antineoplastic chemotherapy. This code is not appropriate for above scenario when patient came for other GI issues (use code as per medical record) not for chemotherapy.


Z92.21 (Personal history of antineoplastic chemotherapy) reported as secondary diagnosis code when patient came for other GI issues. Use this code as secondary diagnosis along with the GI issues (use code as per medical record) as a primary code


Hope this helps!

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