Cracking the Z Codes: Discovering Hidden Treasures with Value-Based Care

Why Should You Attend:

In the ICD-10 classification scheme, Z Codes are found in Chapter 21, “Factors influencing health status and contact with health services (Z00-Z99).” Among these new “Z” codes is the following series related to potential hazards due to family and social circumstances impacting health status:

Note: The chapter specific guidelines provide additional information about the use of Z codes for specified encounters.

1. Use of Z codes in any healthcare setting Z codes are for use in any healthcare setting. Z codes may be used as either a first-listed (principal diagnosis code in the inpatient setting) or secondary code, depending on the circumstances of the encounter. Certain Z codes may only be used as first-listed or principal diagnosis.
2. Z Codes indicate a reason for an encounter Z codes are not procedure codes. A corresponding procedure code must accompany a Z code to describe any procedure performed.

The authors from Health Affairs conclude that: “Identifying a clear process for collecting and aggregating data on social determinants of health is an important next step towards transforming health care, refining value-based payment, and ultimately influencing both health- and non-health-sector strategies to improve population health.”

The opportunity to apply Z-codes that reflect social determinants of health in population health management and payment reform has gained increasing interest and importance in recent years. The inclusion of Z Codes in administrative claims data now allows direct analysis of aspects of the patient’s social environment alongside demographic and clinical factors, and both can be related to utilization and financial outcomes.

There are potential benefits for increased collection and use of social determinants data.

• Patient injury data collected by hospitals
• In identifying population needs for interventions such drowning prevention, firearm safety and bicycle injury prevention, as an example of the public health benefits that can be gained through such data collection, aggregation and analysis.

Areas Covered in the Webinar:

• Find new opportunities to use “Z” codes to report a more accurate encounter
• What “Z” codes can be used as principal diagnosis
• How to code if a condition is discovered during a screening
• Using follow-up codes with history codes to “paint a picture” of patient treatment
• When to assign organ removal codes (e.g., breasts) with associated risk factors
• Code and document reason for encounter and circumstances that may affect a patient’s care and treatment
• Coding routine health examinations and distinguishing between “with” and “without” abnormal findings
• Proper use of counseling “Z” codes when patient or family member receive assistance with coping

Who Will Benefit:

• Medical billing and coding teams
• Auditors
• Medical Practice Managers/Administrators, Physicians Clinical and practice staff involved in coding Compliance Officers/Committees Revenue Cycle Management Professionals

Pamela Joslin
Healthcare Consultant, Independent

Pamela Joslin has more than 20 years of medical practice management, billing and coding, auditing and compliance experience.

She is an engaging presenter via webinar, classroom and conference on every topic that may impact each step in the life of the revenue cycle of every practice.She has managed in medical practices ranging from single to multi-specialty groups, including ASC. She is an advocate of process improvement and maximizing and empowering employees to bring about the "best practice” results for your organization.

She received her Master’s in Management from University of Phoenix. Pam maintains memberships in professional organizations to support her continuing cycle of learning in the ever-changing healthcare industry.Pam is the owner and CEO of her medical consulting firm, Innovative Healthcare Consulting.

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