Cracking the Code
Reporting PRN Medications
It is important for medical coders to understand when to accurately assign codes from category Z79, long-term (current) drug therapy. In order to assign a diagnosis from this subcategory, the provider’s documentation must support a patient receiving a medication for an extensive amount of time. If the provider’s documentation states a patient is receiving medication briefly to treat an acute illness or an as-needed basis (PRN), then it is NOT appropriate to capture a diagnosis from subcategory Z79.
Q: A 40-year-old patient enters the ED with complaints of sore throat, cough, and runny nose. The patient has history of asthma (Fluticasone PRN), GERD (Prilosec once a day), and type 2 diabetes (Metformin once a day). The provider completes a throat swab, which results with a positive status of upper respiratory infection. The provider writes a prescription for Amoxicillin and discharges the patient home.
A: J06.9, acute upper respiratory infection, unspecified; K21.9, gastro-esophageal reflux disease without esophagitis; J45.909, unspecified asthma, uncomplicated; E11.9, type 2 diabetes mellitus without complications; Z79.84, long term (current) use of oral hypoglycemic drugs
Reference: AHA Coding Clinic First Quarter 2021 pages 12-13: Medications used on an as-needed basis