星空入口

Question: Can ICD-10-CM code Z51.11 be used when the provider sees a patient in between treatment for evaluation and management, or is this a code to be used when the patient is physically receiving treatment?

星空入口Forum Participant

Answer: No, the Z51 (Encounter for other aftercare and medical care) codes should not be used for times when a patient is seen by a provider in between treatments.

These codes are exclusively used when the primary purpose of the encounter is to administer chemotherapy, immunotherapy, or radiation therapy. This is according to the guidelines outlined in Chapter 2 of the ICD-10-CM: 鈥淚f a patient admission/encounter is chiefly for the administration of chemotherapy, immunotherapy or external beam radiation therapy assign code Z51.0 [Encounter for antineoplastic radiation therapy], or Z51.11 [Encounter for antineoplastic chemotherapy], or Z51.12 [Encounter for antineoplastic immunotherapy] as the first-listed or principal diagnosis. If a patient receives more than one of these therapies during the same admission, more than one of these codes may be assigned, in any sequence. The malignancy for which the therapy is being administered should be assigned as a secondary diagnosis. If a patient admission/encounter is for the insertion or implantation of radioactive elements, (e.g., brachytherapy) the appropriate code for the malignancy is sequenced as the principal or first-listed diagnosis. Code Z51.0 should not be assigned.鈥�

Lindsey Bush, BA, MA, CPC, Development Editor, AAPC