2025 ICD-10-CM code Z02.71
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Factors influencing health status and contact with health services - Persons encountering health services for examinations Chapter 21: Factors influencing health status and contact with health services Feed
Encounter for disability determination.
Modifiers may be applicable depending on the specific circumstances of the encounter and the payer's requirements.
The medical necessity for code Z02.71 is established by the patient's need for a comprehensive medical evaluation to determine their eligibility for disability benefits or other related services. This evaluation must be performed by a qualified healthcare professional and be supported by appropriate clinical documentation.
The clinical responsibility for code Z02.71 falls on the physician or other qualified healthcare professional conducting the disability evaluation. This includes obtaining a comprehensive history, conducting a physical examination, ordering and interpreting relevant diagnostic tests (if needed),and documenting the findings in a clear and concise manner to support the disability determination.
- Chapter 21: Factors influencing health status and contact with health services
- Z00-Z13: Persons encountering health services for examinations
In simple words: This code is used when someone goes to the doctor to get checked for a disability. The doctor will assess their abilities and limitations to see if they qualify for disability benefits.
This code classifies encounters for the purpose of determining an individual's disability status.It is used when a patient presents to a healthcare provider specifically for an evaluation to assess their functional limitations and determine eligibility for disability benefits or other related services. The assessment may involve various medical, psychological, and/or social evaluations.
Example 1: A patient with a history of back pain and leg weakness seeks evaluation for Social Security Disability Insurance (SSDI) benefits. The physician performs a comprehensive examination, including a neurological assessment and range of motion testing, and completes the necessary documentation for the disability claim., A veteran applies for disability benefits from the Department of Veterans Affairs (VA).A VA physician conducts a detailed medical evaluation to assess the veteran's service-connected disability, including physical and mental health evaluations, and provides a comprehensive report of their findings., An individual involved in a workplace accident requires a comprehensive medical evaluation to determine the extent of their disability and their ability to return to work. The physician's assessment includes functional capacity evaluations and documentation for workers' compensation claims.
* Thorough patient history, including the onset, duration, and character of symptoms.* Detailed physical examination findings.* Results of any relevant diagnostic tests (e.g., imaging studies, laboratory tests).* Functional capacity evaluation results (if applicable).* Assessment of the patient's ability to perform activities of daily living (ADLs) and instrumental activities of daily living (IADLs).* Documentation supporting the medical necessity of the disability evaluation.
** This code is not used for routine checkups or preventative care; it is specifically for evaluating disability.The documentation should clearly link the symptoms, findings, and functional limitations to the disability determination process.
- Payment Status: Active
- Modifier TC rule: Not applicable.
- Specialties:* Internal Medicine* Family Medicine* Neurology* Psychiatry* Physical Medicine and Rehabilitation
- Place of Service:Office, Hospital, Outpatient Clinic