The 2022 edition of ICD-10-CM Z53.9 became effective on October 1, 2021.
Z53.20 Procedure and treatment not carried out because of patient's decision for unspecified reasons. Z53.21 Procedure and treatment not carried out due to patient leaving prior to being seen by health care provider. Z53.29 Procedure and treatment not carried out because of patient's decision for other reasons.
FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016 (First year ICD-10-CM implemented into the HIPAA code set)
The General Equivalency Mapping (GEM) crosswalk indicates an approximate mapping between the ICD-10 code Z16.20 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.
Z16.20 is a billable diagnosis code used to specify a medical diagnosis of resistance to unspecified antibiotic. The code Z16.20 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 Z16.20 might also be used to specify conditions or terms like antibiotic resistant tuberculosis, drug resistance, drug resistance to antibacterial agent, infection due to esbl bacteria or therapy failure due to antibiotic resistance.#N#The code Z16.20 describes a circumstance which influences the patient's health status but not a current illness or injury. The code is unacceptable as a principal diagnosis.#N#Unspecified diagnosis codes like Z16.20 are acceptable when clinical information is unknown or not available about a particular condition. Although a more specific code is preferable, unspecified codes should be used when such codes most accurately reflect what is known about a patient's condition. Specific diagnosis codes should not be used if not supported by the patient's medical record.
Unspecified diagnosis codes like Z16.20 are acceptable when clinical information is unknown or not available about a particular condition. Although a more specific code is preferable, unspecified codes should be used when such codes most accurately reflect what is known about a patient's condition.
The Medicare Code Editor (MCE) detects and reports errors in the coding of claims data. The following ICD-10 Code Edits are applicable to this code:
FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016 (First year ICD-10-CM implemented into the HIPAA code set)
Z53.20 is a billable diagnosis code used to specify a medical diagnosis of procedure and treatment not carried out because of patient's decision for unspecified reasons. The code Z53.20 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 Z53.20 might also be used to specify conditions or terms like 10 year examination not wanted, 15 year examination not wanted, 18 month examination not wanted, 2.5 year examination not wanted, 3.5 year examination not wanted , 4.5 year examination not wanted, etc.#N#The code Z53.20 describes a circumstance which influences the patient's health status but not a current illness or injury. The code is unacceptable as a principal diagnosis.#N#Unspecified diagnosis codes like Z53.20 are acceptable when clinical information is unknown or not available about a particular condition. Although a more specific code is preferable, unspecified codes should be used when such codes most accurately reflect what is known about a patient's condition. Specific diagnosis codes should not be used if not supported by the patient's medical record.
Unspecified diagnosis codes like Z53.20 are acceptable when clinical information is unknown or not available about a particular condition. Although a more specific code is preferable, unspecified codes should be used when such codes most accurately reflect what is known about a patient's condition.
The Medicare Code Editor (MCE) detects and reports errors in the coding of claims data. The following ICD-10 Code Edits are applicable to this code:
The General Equivalency Mapping (GEM) crosswalk indicates an approximate mapping between the ICD-10 code Z78.9 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.
Z78.9 is a billable diagnosis code used to specify a medical diagnosis of other specified health status. The code Z78.9 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 Z78.9 might also be used to specify conditions or terms like abnormal finding on evaluation procedure, abnormal susceptibility to infections, abnormal systolic arterial pressure, absence of therapeutic response, absent response to treatment , acquisition of new antigens, etc. The code is exempt from present on admission (POA) reporting for inpatient admissions to general acute care hospitals.#N#The code Z78.9 describes a circumstance which influences the patient's health status but not a current illness or injury. The code is unacceptable as a principal diagnosis.
The Medicare Code Editor (MCE) detects and reports errors in the coding of claims data. The following ICD-10 Code Edits are applicable to this code:
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.
Z78.9 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.
Check the alphabetic for "Resistance to Drugs", then find the appropriate antibiotc that failed (They're in the V09.X area in the tabular). List the cellulitis first, though - the fact that the antibiotic failed is secondary to the reason the patient had to take it in the first place.
Another code that looked like it might fit somehow is V58.83 - Encounter for therapeutic drug monitoring - it's got a definition note that says " Drug monitoring: measurement of the level of a specific drug in the body, or measurement of a specific function to assess effectiveness of a drug.". It's an aftercare code, though, which indicates that the condition is healing, and treatment is not being directed at a current, acute disease. (The conventions just say to code the disease diagnosis, otherwise.)
This one you have given is closer but I feel that we cannot take it as a "drug resistance" because the documentation is ONLY for "oral administration" as for now. To label a drug to be resistant, it should be resistant to all routes of administration; even those category of "without mention of resisitance to multiple drugs" also do not suit because the organism has to be first of all deemed to be resistant organism which is lacking in our document.