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August 31, 2020

Coding Encounter for Aftercare and Medical Care

Encounter codes for either aftercare or medical care appear in the ICD-10 CM in Chapter 21, "Factors influencing health status and contact with health services". These codes begin with the letter "Z". Aftercare codes are reported when the initial treatment of a disease has been performed and the patient requires continued care during the healing or recovery phase. These codes are not reported for treatment of current or acute disease, in such cases the diagnosis code for the condition should be reported. Exceptions to this rule are the codes Z51.0, Z51.11 and Z51.12

Z51.0 Encounter for antineoplastic radiation therapy
Z51.11 Encounter for antineoplastic chemotherapy
Z51.12 Encounter for antineoplastic immunotherapy

These codes are to be reported first when the patient's encounter is solely to receive radiation therapy, chemotherapy or immunotherapy. Additionally, the diagnosis code for the underlying condition should be reported as well in the secondary condition. Failure to report a diagnosis for the underlying condition for which the treatment is being given, in addition to the Z code may result in claim denial.

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