Resolved Long Term Drug Use

[MaryW_64032]

Long term drug use if a pt Has forgot to take there anticoagulant for three days, I coded the T code and the reason they are taking the anticoagulant. the guideline says The Z79 is used when pt is on long term drug and it’s consecutive use. Since pt missed 3 days I would not code long term anticoagulant use as it is no longer being used consecutively ? Also the final was palpitations so should I even be coding the non ischemic cardiomyopathy which is why the pt is taking the eliquis? Final palpitations. Thank you

 

[Alicia]

Something to remember, "Intent".
What is the reason the pt has not taken the medication for 3 days? Was it prescribed and they didn't take it? Did the provider d/c the med.
Note that if it is prescribed then it is still long term use. The only time you would remove the code is if the medication was no longer going to be used. Even if they switch to another anticoagulant the code remains.

What did the provider state was the reason for the palpitations? The latter is a s/sx so it would not be coded when you have the cardiomyopathy to code.

Let me know if this helps,

 

[Lori]

Code the Condition​

The patient is taking a long-term medication for a specific systemic condition so the first step is coding for that.
Once you know the primary systemic condition, you can code the medication use and any adverse effects that require further attention.

I feel as Alicia does this is more non compliance.

Z91.14 patient's other noncompliance with medication regimen

CD-10-CM Official Guidelines - Z79 Long-term (current) drug therapy

Z79 Long-term (current) drug therapy

Codes from this category indicate a patient’s
continuous use of a prescribed drug (including such
things as aspirin therapy) for the long-term treatment
of a condition or for prophylactic use. It is not for
use for patients who have addictions to drugs. This
subcategory is not for use of medications for
detoxification or maintenance programs to prevent
withdrawal symptoms in patients with drug
dependence (e.g., methadone maintenance for opiate
dependence). Assign the appropriate code for the
drug dependence instead.
Assign a code from Z79 if the patient is receiving a
medication for an extended period as a prophylactic
measure (such as for the prevention of deep vein
thrombosis) or as treatment of a chronic condition
(such as arthritis) or a disease requiring a lengthy
course of treatment (such as cancer). Do not assign a
code from category Z79 for medication being
administered for a brief period of time to treat an
acute illness or injury (such as a course of antibiotics
to treat acute bronchitis).

​

ICD-10 Codes for Long-term Therapies​
Code	Long-term (current) use of
V – Valid For Claim Submission
Z79.01	anticoagulants
Z79.02	antithrombotics/antiplatelets
Z79.1	NSAIDs
Z79.2	antibiotics
Z79.3	hormonal contraceptives
Z79.4	insulin
Z79.51	inhaled steroids
Z79.52	systemic steroids
Z79.810	selective estrogen receptor modulators
Z79.811	aromatase inhibitors
Z79.818	other agents affecting estrogen receptors and estrogen levels
Z79.82	aspirin
Z79.83	bisphosphonates
Z79.84	oral hypoglycemic drugs
Z79.891	opiate analgesic
Z79.899	other drug therapy
H – Not Valid for Claim Submission
Z79	drug therapy
Z79.0	anticoagulants and antithrombotics/antiplatelets
Z79.5	steroids
Z79.8	other drug therapy
Z79.81	agents affecting estrogen receptors and estrogen levels
Z79.89	other drug therapy

 

[MaryW_64032]

Something to remember, "Intent".
What is the reason the pt has not taken the medication for 3 days? Was it prescribed and they didn't take it? Did the provider d/c the med.
Note that if it is prescribed then it is still long term use. The only time you would remove the code is if the medication was no longer going to be used. Even if they switch to another anticoagulant the code remains.

What did the provider state was the reason for the palpitations? The latter is a s/sx so it would not be coded when you have the cardiomyopathy to code.

Let me know if this helps,

pt just forgot to say take the prescribed meds For 3days. So the consecutive verbiage in the long term use doesn’t apply to pt not taking it consecutive for 3 days. even Though he forgot to take them he still is prescribed the meds with the understanding that they will be taken everyday. Even though he didn’t take I would code the medical condition the med was prescribed for and the Z code for long term use and an Underdosing code? No reason given for the palpitations. Thank you

 

[Alicia]

You do not code for underdosing because it was not a dx by the provider. You are making an assumption and putting words in the providers mouth.
Only time you would do that is if the provider stated there was an affect of the pt not taking the medication for three days? Just because they didn't take a med is not a reason to code for it. Now if the pt didn't take the medication and developed a blood clot THAT would be coded for the clot/underdosing.

Code the LTU and Dx for the med. The Palpitations do not code d/t they are a s/sx of the heart condition.

 

[MaryW_64032]

You do not code for underdosing because it was not a dx by the provider. You are making an assumption and putting words in the providers mouth.
Only time you would do that is if the provider stated there was an affect of the pt not taking the medication for three days? Just because they didn't take a med is not a reason to code for it. Now if the pt didn't take the medication and developed a blood clot THAT would be coded for the clot/underdosing.

Code the LTU and Dx for the med. The Palpitations do not code d/t they are a s/sx of the heart condition.

Ok I get it now. Md must state the underdosing. Thank you so much