Q:

Can you use a “Z” code as a primary diagnosis under PDPM and map to a Clinical Category?

 

A:

The ICD-10-CM Coding Guidelines state that some Z-codes can be primary. There are many Z-codes that would not be appropriate to use as primary diagnoses such as “history of” diagnoses or status codes, but surgical and ortho aftercare codes are frequently the primary reason the resident requires admission to the SNF to receive skilled care.

Blog by Eleisha Wilkes, RN, RAC-CTA, Proactive Medical Review

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