ICD Q & A

Ask the Experts: December 15, 2014

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Question: What is the appropriate ICD-9 diagnosis coding for Parkinson's Dementia? Is it 332.0 [294.10] or 331.82?

Answer: Per the ICD-9 index, Dementia, due to or associated with condition(s) classified elsewhere, Parkinson's disease is coded 332.0 +294.11 or 332.0 + 294.10 depending on whether or not behavioral disturbance was present.
- Christina Benjamin, MA, RHIA, CCS, CCS-P

Question: What is the difference between ICD-10-CM categories Z34, Encounter for supervision of normal pregnancy, and Z36, Encounter for antenatal screening of mother and when would they be appropriate to use in the outpatient setting?

Answer: It will depend on the reason for admission. Z34 -- routine outpatient prenatal visits -- is used for routine outpatient prenatal visits when no complications are present, a code from category Z34, Encounter for supervision of normal pregnancy, should be used as the first-listed diagnosis. These codes should not be used in conjunction with chapter 15 codes.

Z36 Encounter for antenatal screening for mother. Z34 is in excludes note 2 for Z36. Excludes note 2 -- indicating that although the excluded condition is not part of the condition it is excluded from, a patient may have both conditions at the same time. Therefore, when an excludes2 note appears under a code, it may be acceptable to use both the code and the excluded code together if supported by the medical documentation.

If appropriate both codes can be coded on the same encounter.

Z36:
Excludes 1:
Abnormal findings on antenatal screening of mother (O28.-)
Diagnostic examination - code to sign or symptom
Encounter for suspected maternal and fetal conditions ruled out (Z03.7-)
Suspected fetal condition affecting management of pregnancy - code to condition in Chapter 15

Excludes 2:
Genetic counseling and testing (Z31.43 - Z31.5)
Routine prenatal care (Z34)
- Bella Logvinov MBA, CCS, CPC


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