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v1.0.0
ICD-10 Guide
ICD-10 CodesZ29.12

Z29.12

Encounter for prophylactic antivenin

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/12/2025

Code Description

ICD-10 Z29.12 is a billable code used to indicate a diagnosis of encounter for prophylactic antivenin.

Key Diagnostic Point:

Z29.12 is utilized during encounters where a patient receives prophylactic antivenin treatment, typically following a known risk of venomous snake bites or other envenomations. This code is crucial in preventive healthcare, as it reflects proactive measures taken to mitigate the risk of serious health complications from venomous bites. Factors influencing the need for prophylactic antivenin include geographic location, occupational hazards (e.g., outdoor workers), and recreational activities (e.g., hiking, camping). Social determinants such as access to healthcare services, education about venomous species, and community awareness programs also play a significant role in the utilization of this code. Preventive care is emphasized, as timely administration of antivenin can prevent severe outcomes, including hospitalization or long-term health issues. Documentation must clearly indicate the reason for the encounter, the patient's risk factors, and any relevant preventive education provided during the visit.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Need for accurate documentation of risk factors and preventive measures
  • Potential for misinterpretation of encounter purpose
  • Variability in clinical guidelines for antivenin administration
  • Differentiation from treatment codes for actual envenomation

Audit Risk Factors

  • Inadequate documentation of the patient's risk factors
  • Failure to link the encounter to preventive education provided
  • Incorrect coding of actual envenomation instead of prophylaxis
  • Lack of clarity on the necessity of antivenin administration

Specialty Focus

Medical Specialties

Primary Care

Documentation Requirements

Documentation should include patient history, risk assessment, and preventive education provided during the encounter.

Common Clinical Scenarios

Routine checkups for patients at risk of snake bites, educational sessions on venomous species.

Billing Considerations

Consideration of social determinants such as access to healthcare and community education on venomous species.

Public Health

Documentation Requirements

Population-level data collection, surveillance of envenomation cases, and preventive outreach documentation.

Common Clinical Scenarios

Community health initiatives aimed at reducing snakebite incidents, epidemiological studies.

Billing Considerations

Focus on tracking health outcomes related to preventive measures and community education.

Coding Guidelines

Inclusion Criteria

Use Z29.12 When
  • Z codes are used to indicate encounters for circumstances other than disease or injury
  • 12 should be used when the encounter is specifically for prophylactic antivenin
  • It should not be used as a primary diagnosis but rather as a secondary code to indicate preventive measures taken
  • Payer requirements may vary, so it is essential to verify coverage for preventive services

Exclusion Criteria

Do NOT use Z29.12 When
No specific exclusions found.

Related CPT Codes

96372CPT Code

Therapeutic, prophylactic, or diagnostic injection into the subcutaneous or intramuscular area

Clinical Scenario

Used when administering prophylactic antivenin during the encounter.

Documentation Requirements

Document the reason for injection, patient education, and any follow-up care instructions.

Specialty Considerations

Primary care providers should ensure comprehensive documentation of preventive measures.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for greater specificity in coding preventive encounters, including Z29.12. This specificity aids in better tracking of preventive measures and health outcomes related to antivenin administration.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for greater specificity in coding preventive encounters, including Z29.12. This specificity aids in better tracking of preventive measures and health outcomes related to antivenin administration.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for greater specificity in coding preventive encounters, including Z29.12. This specificity aids in better tracking of preventive measures and health outcomes related to antivenin administration.

Resources

Clinical References

  • •
    CDC Guidelines on Snakebite Prevention

Coding & Billing References

  • •
    CDC Guidelines on Snakebite Prevention

Frequently Asked Questions

When should Z29.12 be used?

Z29.12 should be used during encounters specifically for prophylactic antivenin administration, particularly when the patient is at risk for venomous snake bites. Documentation must support the preventive nature of the encounter.