Now that we are all familiar with ICD-10 it’s time that we start focusing more on specificity when it comes to diagnosis. It’s not just import for patient charts, with HCC becoming the new standard and payers tracking things like readmissions it’s becoming more important than ever for Coders to capture as much in their code selection as possible.
ICD-10 includes a classification system implemented to capture data, which previously was not tracked. Classifications such as “underdosing of drugs” can prove to be vital when readmission rates are not only tracked but also could affect a practice’s reimbursements. As coders, it’s not only important that we extrapolate this information from the documentation but also code why the drug was not taken correctly or, in some cases, not at all. Classification codes T36-T50 (utilizing a fifth or sixth character of “6”), deals with specific drug underutilization while Z codes Z91.12- Z91.19 classifies the patient’s non-compliance with medical treatment and regimen. Z codes should, when known, be accompanied by the correct underdosing code to help account for intent.
The Journal of AHIMA wrote about this back in 2016, however this topic will continue to become more relevant as Risk Adjustment Models are adapted by more practices and payers.