Ask the Expert

Question:

When would it be appropriate to use Z36, Encounter for antenatal screening of mother, vs Z34.xx Encounter for supervision of normal pregnancy, as it pertains to the hospital outpatient diagnostic setting? Some examples include encounters for lab work, OB ultrasounds, RhoGAM (Rho(D) Immune Globulin (Human)) injections, etc.

Geneve Terry, RHIT
Community Healthcare System
Northwest Indiana

Response:

ICD-10 code Z34.xx, Encounter for supervision of normal pregnancy, is used for a routine outpatient diagnostic visit when no obstetrical complication or condition codes found in Chapter 15, Pregnancy, Childbirth and the Puerperium are applicable to the encounter. (See the ICD-10-CM Official Guidelines for Coding and Reporting, guidelines 1.C.15.b.1., 1.C.21.11 and IV.O.) This code would be assigned when a routine pregnancy laboratory panel was ordered.

ICD-10 code Z36, Encounter for antenatal screening of mother, is used when screening for the testing of disease or disease precursor is performed in patients who are seemingly well for the purpose of early detection and treatment. (See the ICD-10-CM Official Guidelines for Coding and Reporting, guidelines 1.21.c.5.) This code would be assigned when an alpha-fetoprotein protein test was ordered to screen for fetal abnormalities.

— Susan Belley, MEd, RHIA, CPHQ, is manager of clinical content development for 3M Health Information Systems.

Question:

Is it proper to code 530.3 with 787.20 when doing a dilatation, and the reason for doing the procedure is the dysphagia? You can have Schatzki ring and have it be open, so I thought it further explains the reason for the procedure.

Kathy W.

Response:

I understand why you are asking; we have all asked this question! While one of the symptoms of Schatzki ring is difficulty swallowing, this is not always the case. That said, I do feel it would be appropriate to code both. Not necessary, perhaps, but appropriate. After all, our job is to tell the story of what happened during that patient's visit, correct?

— Laurie Ercanbrack, CPC, CCS-P, is coding manager at Coding Concepts LLC.