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Z86.711
ICD-10-CM
History of Pulmonary Embolism

Find comprehensive information on diagnosing a history of pulmonary embolism. This resource covers clinical documentation requirements, medical coding guidelines (ICD-10 Z86.711), risk factors, diagnostic criteria, and best practices for healthcare professionals dealing with patients with a prior PE diagnosis. Learn about the importance of accurate and complete documentation for optimal patient care and appropriate reimbursement. Explore resources related to past pulmonary embolism, previous DVT and PE, recurrent PE prevention, and chronic thromboembolic pulmonary hypertension.

Also known as

Hx of PE
Resolved Pulmonary Embolism
Past Pulmonary Embolism

Diagnosis Snapshot

Key Facts
  • Definition : Prior blockage of lung artery by a blood clot, often originating from a deep vein thrombosis.
  • Clinical Signs : Shortness of breath, chest pain (often pleuritic), cough, rapid heart rate. Prior imaging confirmation.
  • Common Settings : Hospital, outpatient clinic, emergency room follow-up.

Related ICD-10 Code Ranges

Complete code families applicable to AAPC Z86.711 Coding
I26

Pulmonary embolism

Conditions related to past pulmonary emboli.

Z86.71

Personal history of pulmonary embolism

Indicates a past episode of pulmonary embolism.

I27.82

Other chronic pulmonary heart diseases

May include chronic conditions resulting from a past PE.

Code-Specific Guidance

Decision Tree for

Follow this step-by-step guide to choose the correct ICD-10 code.

Is the pulmonary embolism currently active?

  • Yes

    Do NOT code as history of. Code the acute pulmonary embolism (I26.9 or I26.0-I26.99).

  • No

    Any residual effects from the past PE?

Code Comparison

Related Codes Comparison

When to use each related code

Description
Pulmonary Embolism
Deep Vein Thrombosis
Chronic Thromboembolic Pulmonary Hypertension

Documentation Best Practices

Documentation Checklist
  • Document DVT symptoms: extremity pain, swelling, redness
  • Record Wells score and Geneva score assessment results
  • Specify diagnostic imaging used: CTPA, VQ scan
  • Detail prior PE diagnoses, treatments, or complications
  • Note risk factors: immobility, surgery, family history

Coding and Audit Risks

Common Risks
  • Unspecified acuity

    Coding for history of PE lacks acuity specificity (acute, chronic, resolved) impacting risk adjustment and quality reporting.

  • Unconfirmed diagnosis

    History of PE coded without sufficient documentation, posing a compliance risk for inaccurate claims submission.

  • Conflicting information

    Discrepancy between physician documentation and patient reported history of PE requiring CDI clarification for accurate coding.

Mitigation Tips

Best Practices
  • Document PE risk factors: immobility, surgery, etc.
  • Specify PE diagnostic method: CTA, VQ scan results
  • Clearly state 'history of PE' with date of diagnosis
  • Code Z86.711 for personal history of pulmonary embolism
  • For chronic effects, code sequelae (I26.92) if applicable

Clinical Decision Support

Checklist
  • Verify prior imaging report confirms PE diagnosis (ICD-10 I26.9)
  • Check for documented D-dimer, CTA, or VQ scan results
  • Confirm documented anticoagulation treatment details and duration
  • Assess patient risk factors for VTE recurrence (Wells criteria)

Reimbursement and Quality Metrics

Impact Summary
  • Pulmonary Embolism coding accuracy impacts MS-DRG assignment and reimbursement.
  • History of Pulmonary Embolism diagnosis affects quality reporting metrics like VTE readmission rates.
  • Proper ICD-10-CM Z86.711 code use is crucial for accurate history of PE claims.
  • Accurate coding impacts hospital profiling and value-based purchasing programs.

Streamline Your Medical Coding

Let S10.AI help you select the most accurate ICD-10 codes for . Our AI-powered assistant ensures compliance and reduces coding errors.

Quick Tips

Practical Coding Tips
  • Code Z86.711 for history of PE
  • Document PE episode details
  • Specify acute or chronic PE
  • Consider I26.99 for other sequelae
  • Query physician for clarity

Documentation Templates

Patient presents with a history of pulmonary embolism (PE).  The initial diagnosis of PE was made on [Date of initial PE diagnosis] based on [Basis of initial diagnosis; e.g., positive CT pulmonary angiography, high probability VQ scan, D-dimer elevation in conjunction with concerning clinical presentation].  The patient's presenting symptoms at that time included [List initial symptoms; e.g., dyspnea, chest pain, cough, hemoptysis].  Risk factors for venous thromboembolism (VTE) identified at the time of diagnosis included [List risk factors; e.g., recent surgery, prolonged immobilization, active malignancy, family history of VTE, inherited thrombophilia, oral contraceptive use, hormone replacement therapy, pregnancy, postpartum status].  The patient was treated with [Specify initial treatment regimen; e.g., anticoagulation with warfarin, rivaroxaban, apixaban, dabigatran, low molecular weight heparin].  Duration of anticoagulation was [Specify duration; e.g., 3 months, 6 months, indefinitely].  Current symptoms related to the history of PE include [List current symptoms; e.g., residual dyspnea on exertion, chest discomfort].  The patient's current medication regimen includes [List current medications, including anticoagulants if applicable].  Physical examination reveals [Document relevant physical exam findings; e.g., clear lung sounds, normal heart rate and rhythm, no lower extremity edema].  Assessment:  History of pulmonary embolism.  Plan:  [Outline plan; e.g., continue current anticoagulation regimen, monitor for recurrent VTE, patient education regarding signs and symptoms of recurrent PE, follow-up appointment scheduled for [date]].  ICD-10 code: I26.99 (Other pulmonary embolism).  Medical billing codes may include [List relevant billing codes; e.g., 99213 for office visit, appropriate codes for any diagnostic testing or procedures performed].