2025 ICD-10-CM code Z01.812
(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 preprocedural laboratory examination; blood and urine tests before a treatment or procedure.
Modifiers are not applicable to ICD-10 codes.Modifiers are used with CPT and HCPCS codes to provide additional information about the services provided.
Medical necessity is established by the physician's determination that preprocedural laboratory tests are required to evaluate the patient's health status and suitability for the planned procedure, thereby potentially preventing complications or altering the plan of care.
The clinical responsibility lies with the physician ordering and interpreting the preprocedural laboratory tests. This may involve a primary care physician, specialist, or the anesthesiologist depending on the context. The lab performing the tests has the responsibility of accurate performance and reporting.
- Chapter 21: Factors influencing health status and contact with health services
- Z01.812 falls under the broader category of Z00-Z13 (Persons encountering health services for examinations) within Chapter 21 of the ICD-10-CM.
In simple words: This code means the patient went to the doctor or lab for blood and urine tests before a planned medical procedure or treatment. These tests help doctors decide if the patient is healthy enough for the procedure and to plan the best treatment.
This ICD-10-CM code signifies an encounter with healthcare services specifically for preprocedural laboratory examinations.These examinations involve tests conducted on blood and/or urine samples to assess a patient's health status before a planned medical procedure or treatment. The purpose is to evaluate suitability for the procedure and inform treatment decisions, potentially revealing contraindications or requiring adjustments to the planned intervention.It is crucial that the code is used only when the laboratory examinations are specifically undertaken for a pre-existing scheduled procedure.It should not be used as the principal diagnosis.
Example 1: A patient is scheduled for a cardiac catheterization.Prior to the procedure, blood tests (including a complete blood count and coagulation studies) and a urinalysis are performed.Z01.812 is used to code the encounter for these preprocedural laboratory tests. The primary diagnosis would be the reason for the catheterization (e.g., suspected coronary artery disease)., A patient is scheduled for elective surgery. Preoperative blood work (including a complete metabolic panel and liver function tests) and a urine sample for drug screening are ordered to assess the patient's overall health and risk factors before surgery. Z01.812 would code the encounter for these tests, along with the appropriate ICD-10 code for the reason for the surgery., A patient is undergoing a series of pre-transplant evaluations before a kidney transplant. Blood work, urine tests, and infectious disease screening are completed as part of the pre-transplant evaluation.Z01.812 can be used to code the encounter for these tests.Appropriate ICD codes related to the transplant evaluation would also be included.
Documentation should include the physician's order for the preprocedural laboratory tests, the specific tests performed, the test results, and the date and time of the tests. A link to the planned procedure should also be present.
** Z01.812 is generally not acceptable as a principal diagnosis in most settings.It should be used as a secondary diagnosis when the reason for the encounter is a preprocedural lab examination.
- Revenue Code: Revenue codes will vary depending on the specific services provided and the payer. Consult your payer's guidelines for appropriate revenue codes.
- RVU: RVUs are not directly associated with ICD-10 codes.RVUs are associated with CPT codes which describe the procedures performed.The RVUs for any associated procedures would need to be determined based on the CPT code(s) used.
- Global Days: Not applicable. Global days are associated with surgical procedures identified by CPT codes, not ICD-10 diagnosis codes.
- Payment Status: Active
- Modifier TC rule: Not applicable to ICD-10 codes.
- Fee Schedule: Not applicable.Fee schedules are associated with CPT and HCPCS codes, not ICD-10 codes.
- Specialties:All medical specialties may use this code as preprocedural lab tests are common to many medical fields.
- Place of Service:Office, Hospital (Inpatient or Outpatient), Ambulatory Surgical Center, Independent Laboratory, Other Place of Service (depending on where the test was performed).