2025 ICD-10-CM code Z01
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Factors influencing health status and contact with health services - Encounter for other special examination without complaint, suspected or reported diagnosis Factors influencing health status and contact with health services (Z00-Z99) Feed
Encounter for other special examination without complaint, suspected, or reported diagnosis.A procedure code is required if one was performed.
Modifiers are not used with ICD-10 codes. Modifiers are used with CPT and HCPCS codes.
Medical necessity would depend on the specific reason for the examination. Preventative screenings may be covered under wellness programs; others might require additional documentation to support medical necessity based on the patient's risk factors or other clinical indicators.
The clinical responsibility depends on the specialty of the physician performing the examination and the body system being examined. It could range from a general practitioner conducting a routine check-up to an ophthalmologist performing a detailed eye examination.
- Factors influencing health status and contact with health services (Z00-Z99)
- Z00-Z13 (Persons encountering health services for examinations)
In simple words: This code means the patient went to the doctor for a specific checkup or test, but they didn't have any symptoms or known problems. If the doctor did any tests or procedures, an extra code is needed to show what those were.
This ICD-10-CM code, Z01, signifies an encounter for a special examination where there is no complaint, suspected diagnosis, or reported diagnosis. This code is used when a patient seeks a specific examination of a body system or function without presenting any symptoms or concerns. It is crucial to note that if a procedure was performed during the examination, a separate procedure code must be added to accurately reflect the services provided.The code includes routine examinations of specific systems but excludes examinations for administrative purposes (Z02.-), examinations for suspected conditions later proven nonexistent (Z03.-), and laboratory/radiological examinations as part of general medical examinations (Z00.0-).
Example 1: A patient with no symptoms requests a routine eye examination., A patient requests a comprehensive hearing test as part of a preventative health checkup., A patient undergoes a routine EKG as part of a pre-employment physical. No cardiac symptoms are reported.
Documentation should include the reason for the examination, a description of the examination performed, and the findings.If any procedures were completed, these should be documented thoroughly as well.
** Always ensure that a procedure code is included if any tests or procedures were completed during the examination.The choice of procedure code(s) will determine the payment.Accurate documentation is paramount for appropriate reimbursement.
- Revenue Code: Revenue codes will depend on the specific procedure performed, if any. Consult your local payer's guidelines.
- RVU: RVUs are not applicable to ICD-10 codes. RVUs are associated with CPT codes which represent procedures or services rendered.
- Global Days: Not applicable to ICD-10 codes.Global periods apply to surgical procedures coded with CPT codes.
- Payment Status: Active
- Modifier TC rule: Not applicable to ICD-10 codes.
- Fee Schedule: Not applicable to ICD-10 codes.
- Specialties:The specialty will vary depending on the system examined. This could include family medicine, ophthalmology, audiology, cardiology, or other specialties depending on the context of the visit.
- Place of Service:Office, Clinic, Hospital (Inpatient or Outpatient),Ambulatory Surgical Center, etc.