Q&A Noncompliance/underdosing

[Kim Pressley]

I am going through the 2015 Coding Handbook for CM and PCS. One of the questions to code was "Noncompliance with medication, unintentional, due to patient's advanced age." I chose "Z91.14 - Patient's other noncompliance with medication regimen." However, the correct answer was "Z91.130 - Underdosing of medication regimen due to age-related debility." The question is, is the default for noncomplaince "underdosing" if not specified to obtain the surrounding specificity. Just trying to understand when it is safe to assume underdosing.

 

[Melissa Caswell]

When looking up the main term Noncompliance in the alphabetical index, go down to medication regimen then underdosing, then unintentional, then due to patient's age related debility. The statement listed follows that mapping. Underdosing refers to taking less of a medication than is prescribed. The Z codes for noncompliance are to be used with an underdosing code to indicate intent. So, when mapping a code we need to follow the alphabetic index then verify in the tabular. We know noncompliance. We know it was medication. Then, unintentional and the last statement due to age-related debility leads us to the last subterm which brings us to code Z91.130. In this case, we do not have the medication information to code the actual underdosing T Code.

 

[Laureen]

Great question Kim and wonderful thorough answer Melissa - thank you!