ICD-10 coding Q&As

August 28, 2015
AOA's Coding Experts share more solutions to your ICD-10 coding conundrums.

Ask the Coding Experts, by Doug Morrow, O.D., Harvey Richman, O.D., and Rebecca Wartman, O.D.

From the July/August 2015 edition of AOA Focus, page 49.

AOA's Coding Experts share more solutions to your coding conundrums.

When reporting ICD-10 codes, when is it appropriate to use the family history diagnosis codes?

With regard to use of the family history diagnosis codes, the ICD-10 Official Guidelines for Coding and Reporting indicate:

There are two types of history Z codes, personal and family. Personal history codes explain a patient's past medical condition that no longer exists and is not receiving any treatment, but that has the potential for recurrence, and therefore may require continued monitoring. Family history codes are for use when a patient has a family member(s) who has had a particular disease that causes the patient to be at higher risk of also contracting the disease. Personal history codes may be used in conjunction with follow-up codes and family history codes may be used in conjunction with screening codes to explain the need for a test or procedure. History codes are also acceptable on any medical record regardless of the reason for visit. A history of an illness, even if no longer present, is important information that may alter the type of treatment ordered.

As is noted in the guidelines, the family history diagnosis codes should be used if a patient is at higher risk for a disease due to family history or if the doctor is conducting a screening based in part on family history. For example, if an doctor of optometry was treating a 60-year-old patient, the patient had not had an eye exam in several years and the patient had a family history of glaucoma, the doctor should report the patient's family history of glaucoma using the ICD-10 code Z83.511 (family history of glaucoma). The complete guidelines can be accessed on the CMS website.

I am retiring from practice in 2016. Does AOA have resources that can help me learn about ICD-10 to get through my remaining months in practice

We highly recommend ordering the AOA's Codes for Optometry manual, available to members by calling the AOA Marketplace at 800.262.2210 or by visiting the AOA Marketplace.

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