Awareness : OBC Tips

What Does the Z00.6 Diagnosis Code Tell the Payor and When is it Required?  What is Condition Code 3

The Z00.6 diagnosis code reports that the service involved “Encounter for examination for normal comparison and control in clinical research program”.

The Z00.6 diagnosis code must be used for all services provided as part of a Qualified Clinical Trial or approved study, even if it would otherwise be standard of care for the patient absent the trial. 

What does the Condition Code 30 tell the payor?

Condition Code 30 means “qualified clinical trial” and it must appear on the hospital inpatient or outpatient claim when billing for items/services related to a Qualified Clinical Trial or approved study regardless of whether all services on the claim are related to the clinical trial or not.