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2025 ICD-10-CM code Z01.84

Encounter for antibody response examination; used when an antibody test is performed, but it's neither to confirm a current infection nor for follow-up of a known infection.

Adhere to the official ICD-10-CM coding guidelines published by the Centers for Medicare & Medicaid Services (CMS).

Modifiers are not applicable to ICD-10 codes.

Medical necessity for antibody testing varies depending on the specific antibody, the patient's risk factors, and the clinical context.Documentation should justify the need for the test based on established medical guidelines and the patient's unique circumstances.

The clinical responsibility lies with the physician or healthcare professional ordering and interpreting the antibody test. This includes ensuring the appropriate clinical indication for testing, obtaining informed consent, and properly interpreting the results to guide patient management.

IMPORTANT:If the antibody test is for a current COVID-19 infection, code U07.1 should be used along with codes for any symptoms.If the test is for a suspected exposure to COVID-19 without symptoms which is ruled out after testing, Z20.828 (contact with and [suspected] exposure to other viral communicable diseases) is appropriate. For asymptomatic individuals with a history of COVID-19, Z09 codes might be considered.For screening purposes, particularly during a pandemic, Z11.59 (Encounter for screening for other viral diseases) or other specific screening codes may be more appropriate, depending on the circumstances.

In simple words: This code is used when someone goes to the doctor for a blood test to check their antibody levels, but it's not because they're currently sick or recovering from a previous illness.The test is to see if they have antibodies to a specific disease.

This ICD-10-CM code (Z01.84) signifies an encounter for the purpose of conducting an antibody response examination.This code is applied when a patient undergoes antibody testing that is not intended to confirm an active infection or monitor a known prior infection. It's crucial to differentiate this from situations involving active or previously diagnosed infections, which necessitate alternative coding.

Example 1: A patient with no known exposure to measles undergoes an antibody test to determine prior immunity.Code Z01.84 is used.No other diagnoses are present., A healthcare worker undergoes routine antibody testing for various infectious diseases as part of their annual health assessment. Z01.84 is used to represent this examination., A patient presents for a routine check-up.As part of this examination, an antibody test for rubella is ordered.Z01.84 is reported along with a Z00 code for the general examination.

The medical record should clearly document the reason for ordering the antibody test. This should explicitly state that the test is not for confirming a current or past infection.The test results should also be documented.

** This code is primarily used for encounters solely for antibody testing where there is no suspicion or diagnosis of an active infection or a history of a specific infection.Always ensure the documentation supports the use of this code, and consider other more specific codes if applicable.

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