Tune in to this monthly online coding column, facilitated by AHIMA’s coding experts, to learn about challenging areas and documentation opportunities for ICD-10-CM/PCS.
By Chrystel Barron, RHIT, CCS, CHTS-TR
It is important to know the difference between anticoagulant drugs and antiplatelet drugs when assigning a Z-code for long term drug use. Both of these types of drugs are closely related in the way they manipulate the various channels of the blood clotting mechanism, which can make this a confusing task. Anticoagulants, more commonly referred to as “blood thinners,” work by inhibiting the clotting factors. Antiplatelets work by inhibiting the enzymes that cause the platelets to clump together.
Both anticoagulant and antiplatelet drugs are technically classified as antithrombotic drugs, and this is where the confusion originates.1 Look, for example, at the description of code Z79.02, Long term (current) use of antithrombotics/antiplatelets. Even though this code includes antithrombotic we know that long term use of anticoagulants should not be assigned to Z79.02 since a more appropriate code can be found at Z79.01, Long term (current) use of anticoagulants. Code Z79.02 should be assigned for those antithrombotic drugs that are further classified as antiplatelet drugs. Even aspirin can be used as an antiplatelet, but there is a more specific code for long term use of aspirin: Z79.82, Long term (current) use of aspirin. It is important for coding professionals to review all codes in the related area of the ICD-10-CM codebook tabular to determine if a more appropriate code is available.
Remember, the Centers for Medicare and Medicaid Services’ Official Guidelines for Coding and Reporting state that codes from category Z79 can be assigned if the patient is receiving the medication for an extended period as a prophylactic measure or as treatment of a chronic condition or a disease requiring a lengthy course of treatment.
The table below shows the most common anticoagulants and antiplatelets and the correct long term drug use code that would be assigned.
- Hirsh, Jack. “Antithrombotic Therapy.” 50 Years in Hematology: Research That Revolutionized Patient Care. pp. 28-31. http://www.hematology.org/About-ASH/50-Years.aspx.
Chrystel Barron (firstname.lastname@example.org) is the coding education instructor for the Cleveland Clinic Health System.