![]() It is imperative to find out what the parents are worried about. In this situation, you don’t need a Z code. To support this E/M code, you should use otalgia (the affected ear was not specified, so the code would be H92.09) as the primary diagnosis. The child is well, but you need to spend extra effort to determine this, warranting an E/M code such as 99213 (Office or other outpatient visit for the evaluation and management of an established patient…). On exam, the child has no fever and the ears look fine. The mother brings in an infant saying that the baby has been pulling at his ears. Here, no specific feared condition is present, making Z03.89 your best bet. The parent may have to pay for this visit as insurance will often (but not always) deny payment for this diagnosis code. This is a perfect place to use Z03.89 all by itself because there is no other problem present. There are no signs, symptoms or problems other than the fact that the mom wanted to make sure that the cold is gone. “Just because I want to make sure everything is OK and the cold is gone,” the mom tells you. How to apply it:Ī mother brings her child who recently got over a cold to the pediatrician prior to a cross country trip to see family. Z03.89 (Encounter for observation for other suspected disease and condition, ruled out), could be appropriate for these cases, particularly for those instances when a parent fears the patient has a problem but the visit results in no diagnosis. Your answer can be the appropriate “Z” Code. ![]() Obviously you cannot bill for parental anxiety, but you can bill for the symptoms. The question remains, how do you code for this kind of visit? Once the visit is completed there is nothing wrong. This can also be related to older children that may have had a sprain or fracture. Or maybe they have a cranky child who has had a previous ear infection that they simply want to have checked. The visit could be for a six-month-old child whose mother thinks they might be teething. Many times parents want to bring in the child just to make sure everything is ok. The health and well-being of the baby is priority one. Being a parent of a new baby can be very challenging.
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