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Jamie Posted 1 Year(s) ago
When a Female comes in for a prev exam, and providers do a comprehensive exam to include the genitourinary organ system we code Z01.419 as long as there are no abnormal findings. Are we also required to code Z00.00 to cover all the other organ systems or is it only necessary to code one or the other? Z01.419 (genitourinary, breasts) Z00.00(HEENT, Cardiovascular, respiratory, gastrointestinal, musculoskeletal, integumentary, ect)
SuperCoder Posted 1 Year(s) ago

Hi Jamie,

When a patient comes in for annual (general) preventive exam, we will just bill Z00.00.  It is important to note that this code specifically indicates that no abnormal findings were detected. If your records mention GYN Annual exam we will go for Z01.419. Also, Preventive medicine codes (e.g. 99397) billed with a gynecological diagnosis code (e.g. ICD-10 Z01.419) will be denied as a provider write-off. Thank you.

Jamie Posted 1 Year(s) ago
Why would Preventative medicine codes (e.g.99397) billed with Z01.419 be denied as provider write off if the patient is receiving a GYN Exam? Should Z01.419 only be used by a GYN Provider?
SuperCoder Posted 1 Year(s) ago

Hi Jamie,

There is no such rule that ICD Z01.419 will only be used by a GYN Provider. Also, Preventative medicine codes (e.g.99397) billed with Z01.419 be denied as provider write off if the patient is receiving a GYN Exam with some specific insurence companies. So, one needs to check with the payer before billing. Please check with below link for further clarity. Hope it helps.

https://www.modahealth.com/pdfs/reimburse/RPM044.pdf

 

 

Posted by Jamie, 1 Year(s). There are 4 posts. The latest reply is from SuperCoder.

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