Medication surveillance, antihypertensive. Monitoring of long term therapeutic drug use done. Opioid dependence (moderate use disorder) on agonist therapy, in early remission. Opioid dependence (moderate use disorder) on agonist therapy, in sustained remission.
Opioid dependence (severe use disorder) on agonist therapy, in sustained remission. Opioid dependence, moderate use, on agonist therapy, in early remission. Opioid dependence, moderate use, on agonist therapy, in sustained remission. Opioid dependence, severe use on agonist therapy, in early remission.
Long term current use of leflunomide (arava) Long term current use of lenalidomide (revlimid) Long term current use of lithium. Long term current use of medication for add and or adhd. Long term current use of medication for attention deficit disorder (add) or attention deficit hyperactivity disorder (adhd)
Z51.81 is a billable diagnosis code used to specify a medical diagnosis of encounter for therapeutic drug level monitoring. The code Z51.81 is valid during the fiscal year 2021 from October 01, 2020 through September 30, 2021 for the submission of HIPAA-covered transactions.#N#The ICD-10-CM code Z51.81 might also be used to specify conditions or terms like antihypertensive agent surveillance done, asthma monitoring status, attends hormone replacement monitoring, bronchodilators used a maximum of once daily, bronchodilators used more than once daily , bronchodilators used once daily, etc. The code is exempt from present on admission (POA) reporting for inpatient admissions to general acute care hospitals.
Type 1 Excludes. A type 1 excludes note is a pure excludes note. It means "NOT CODED HERE!". An Excludes1 note indicates that the code excluded should never be used at the same time as the code above the Excludes1 note.
Diagnosis was not present at time of inpatient admission. Documentation insufficient to determine if the condition was present at the time of inpatient admission. Clinically undetermined - unable to clinically determine whether the condition was present at the time of inpatient admission.
An Excludes1 is used when two conditions cannot occur together, such as a congenital form versus an acquired form of the same condition . encounter for blood-drug test for administrative or medicolegal reasons Z02.83.
Z51.81 is exempt from POA reporting - The Present on Admission (POA) indicator is used for diagnosis codes included in claims involving inpatient admissions to general acute care hospitals. POA indicators must be reported to CMS on each claim to facilitate the grouping of diagnoses codes into the proper Diagnostic Related Groups (DRG). CMS publishes a listing of specific diagnosis codes that are exempt from the POA reporting requirement. Review other POA exempt codes here.
The General Equivalency Mapping (GEM) crosswalk indicates an approximate mapping between the ICD-10 code Z79.899 its ICD-9 equivalent. The approximate mapping means there is not an exact match between the ICD-10 code and the ICD-9 code and the mapped code is not a precise representation of the original code.
The Index to Diseases and Injuries is an alphabetical listing of medical terms, with each term mapped to one or more ICD-10 code (s). The following references for the code Z79.899 are found in the index:
Z79.899 is exempt from POA reporting - The Present on Admission (POA) indicator is used for diagnosis codes included in claims involving inpatient admissions to general acute care hospitals. POA indicators must be reported to CMS on each claim to facilitate the grouping of diagnoses codes into the proper Diagnostic Related Groups (DRG). CMS publishes a listing of specific diagnosis codes that are exempt from the POA reporting requirement. Review other POA exempt codes here.
“Drug therapy requiring intensive monitoring for toxicity: A drug that requires intensive monitoring is a therapeutic agent that has the potential to cause serious morbidity or death.
Long-term intensive monitoring is not less than quarterly. The monitoring may be by a lab test, a physiologic test or imaging. Monitoring by history or examination does not qualify. The monitoring affects the level of medical decision making in an encounter in which it is considered in the management of the patient.
When deciding whether to assign high risk, both the drug and the monitoring need to qualify. Doing bi-weekly lab or monthly lab tests, or following in the office every three months is not intensive monitoring. For some of the medications, the initiation of the treatment may require frequent lab tests, phone calls and office visits.
There is no definitive citation to guide a coder or clinician in either the list of drugs or what qualifies as “frequent monitoring.”. In 2021, CPT is revising the definitions for new and established patients, 99202–99215. (99201 will be deleted in 2021.)
Answer: CMS itself has not provided such a list for use with the 1995 or 1997 guidelines. This question is answered from those guidelines, but the end of the Q&A discusses the 2021 CPT changes. Palmetto Medicare has a list of drugs requiring intensive monitoring.