Our office is having a discussion regarding whether or not to add a diagnosis code for refills during an encounter. Often times our providers will write a refill on a RX which the patient originally received from a specialist. There are no notations within the record other than the notation under Orders for that encounter date.
if you look in the coding guidelines the V68.x code which you would use for prescription refills is valid only as a first listed dx code.
Short description: Issue repeat prescript. ICD-9-CM V68.1 is a billable medical code that can be used to indicate a diagnosis on a reimbursement claim, however, V68.1 should only be used for claims with a date of service on or before September 30, 2015.
repeat prescription (appliance) (glasses) (medicinal substance, medicament, medicine) Z76.0 Reimbursement claims with a date of service on or after October 1, 2015 require the use of ICD-10-CM codes.
ICD-10 Code for Encounter for issue of repeat prescription- Z76. 0- Codify by AAPC.
Encounter for issue of repeat prescription 0 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2022 edition of ICD-10-CM Z76. 0 became effective on October 1, 2021. This is the American ICD-10-CM version of Z76.
The patient's primary diagnostic code is the most important. Assuming the patient's primary diagnostic code is Z76. 89, look in the list below to see which MDC's "Assignment of Diagnosis Codes" is first.
7: Will ICD-10 codes be required on an electronic prescription? If the resulting claim requires a diagnosis code and a diagnosis code would have been required on a paper prescription, then an ICD-10-CM code would need to be submitted on the electronic prescription.
ICD-9 Code Transition: 786.5 Code R07. 9 is the diagnosis code used for Chest Pain, Unspecified. Chest pain may be a symptom of a number of serious disorders and is, in general, considered a medical emergency.
Even if there is no history, exam or medical decision making involved (as in the prescription refill example), you can always code the encounter as a 99211.
ICD-10-PCS GZ3ZZZZ is a specific/billable code that can be used to indicate a procedure.
Encounter for therapeutic drug level monitoring. Z51. 81 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes.
Pharmacies will have to wait for medical industry professionals to role out ICD-10 codes. This may mean a pharmacist having to contact the healthcare provider to verify an ICD-10, if it is missing from a prescription.
Exceptions: A diagnosis code is rarely required on a pharmacy claim. A diagnosis code is required when the recipient is enrolled in the “Be Smart” Family Planning Program and the claim is for a drug that is used to treat an STI.
ICD-10 is the10th revision of the International Classification of Diseases, which provides the medical data code sets for coding diagnoses (ICD-10-CM).