Fee-for-service coverage of ICD-10 codes Z09 and Z01.818

The Oregon Health Authority (OHA) is updating systems to show that ICD-10 codes Z09 (Encounter for follow-up examination after completed treatment for conditions other than malignant neoplasm) and Z01.818 (Encounter for other preprocedural examination) are open for payment, effective October 1, 2015.  OHA groups diagnosis codes as undefined, informational, and diagnostic workup. Only diagnostic workup codes are open for payment. Z09 and Z01.818 originally were listed as informational diagnosis codes. After consulting with the Health Evidence Review Commission, OHA concluded that these codes should be listed as diagnostic workup codes, and open for payment. They updated Z09 on May 12, 2016, and updated Z01.818 on November 9, 2016. To be paid for services billed to OHA with Z09 or Z01.818 as the primary diagnosis, please rebill OHA.