Chapter XXI - Factors influencing health status and contact with health services

Question 1

When must codes from U82, U83, U84 be assigned secondary to Z22.3 Carrier of other suspected specified bacterial diseases?

Answer 1

When the responsible consultant has documented that the patient is a carrier of drug resistant bacterial diseases, to identify the drug the bacteria is resistant to.

Question 2

When can codes in categories Z00-Z13 Persons encountering health services for examination and investigation be assigned in a primary position?
What are the exceptions?

Answer 2

• Only in primary when there is no diagnosis, complication, injury, symptom or abnormal finding code that could be used to explain the encounter instead.
• Exceptions (NEVER in primary):
  1. Z02.- Examination and encounter for administrative purposes
  2. Z10.- Routine generak health check-up of defined subpopulation
• Z08.-/Z09.- Follow-up examination codes (seperate standard)

Question 3

What are the fourth character code assignments at categories Z08.- and Z09.- dependent on? (follow-up examination codes)

Answer 3

The type of treatment the patient received for the original condition.

Question 4

Which fourth character code from Z53.- Persons encountering health services for specific procedures, not carried out must be assigned when the procedure is cancelled due to a lack of theatre space?

Answer 4

Z53.8 Procedure not carried out for other reasons

Question 5

Which are the only two personal history codes that can be assigned in a primary position?

Answer 5

• Z85.6 Personal history of leukaemia
• Z85.7 Personal history of other malignant neoplasms of lymphoid, haematopoietic and related tissues

Question 6

Which position should code Z75.1 Persons awaiting admission to adequate facility elsewhere be assigned?

Answer 6

Only in a secondary position

Question 7

Describe the standard DCS.XXI.8: Renal dialysis (Z49 and Z99.2)

Answer 7

• Codes in category Z49.- Care involving dialysis - NEVER in primary
• Patient admitted for renal dialysis preparation/treatment - code Z49.- secondary to the code for the renal condition or which they are undergoing dialysis
• Patient admitted for other treatment but received dialysis whilst in hospital - do not assign Z49.-
• Z99.2 Dependence on renal dialysis - must be assigned secondary for all patients on a regular programme of dialysis treatment, regardless of whether they are attending for dialysis.

Question 8

If a patients procedure is cancelled due to another medical problem that makes it inadvisable to perform the procedure, how should this be coded?

Answer 8

1. Code for the condition prompting the admission
2. **Z53.- ** (cancelled procedure code)
3. Code for the condition/problem making it inadvisable to perform the procedure

Question 9

When can the code Z60.2 Living alone be assigned?

Answer 9

Only when it is evident from the medical record that the fact the patient lives alone has extended their length of stay.

Must never be coded on an episode where the patient dies.

Question 10

If a patient is admitted for holiday relief care and they receive the same level of care they normally would, how should this be coded?

Answer 10

• Z75.5 Holiday relief care in primary
• Chronic condition in secondary

Question 11

If a patient is admitted for holiday relief care but the patient received care for a different condition and this becomes the main condition treated, how should this be coded?

Answer 11

• Condition now being treated in primary
• Z75.5 Holiday relief care in secondary
• Chronic condition in addition

Question 12

If a patient is admitted for holiday relief care but the consultant decides the patient requires additional treatment for the chronic condition, over and above what they would normally have, how should this be coded?

Answer 12

• Chronic condition in primary
• Z75.5 Holiday relief care in secondary