2025 ICD-10-CM code Z13.7
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Encounter for examination - Special screening examination Factors influencing health status and contact with health services (Z00-Z99) Feed
Encounter for screening for genetic and chromosomal anomalies.
Modifiers may apply depending on the specific services performed and the context of the encounter. Consult appropriate coding guidelines for details.
Medical necessity is established based on factors such as family history of genetic disorders, advanced maternal age (in pregnant women), prior history of genetic abnormalities, ethnicity, and other relevant risk factors.Specific guidelines and coverage may vary by payer.
The clinical responsibility lies with the physician or genetic counselor who orders and interprets the screening tests. This may involve taking a detailed family history, performing a physical examination, ordering appropriate genetic tests (karyotyping, chromosomal microarray analysis, etc.), and counseling the patient on the results.
- Factors influencing health status and contact with health services (Z00-Z99)
- Z13- Special screening examinations
In simple words: This code is used when someone goes to a doctor or clinic specifically for testing to check for birth defects, physical abnormalities, or problems with their chromosomes.
This code signifies an encounter for a special screening examination focused on identifying congenital malformations, deformations, and chromosomal abnormalities.It is used when a patient presents specifically for this type of screening, and no other significant diagnostic or treatment is performed during the encounter.The screening may involve various genetic tests and analyses.
Example 1: A pregnant woman undergoes a non-invasive prenatal screening (NIPS) test to assess the risk of chromosomal abnormalities in her fetus., A newborn infant is screened for genetic disorders through newborn screening programs mandated by the state., An adult patient with a family history of genetic disorders undergoes genetic testing to assess their personal risk.
Detailed family history, reason for screening (e.g., family history, advanced maternal age), specific tests performed, test results, and genetic counseling provided (if applicable).
** This code is frequently used in conjunction with other codes to capture the complexity of genetic testing and counseling.Accurate documentation is essential for proper billing and reimbursement.
- Payment Status: Active
- Modifier TC rule: Not applicable.
- Specialties:Obstetrics and Gynecology, Genetics, Pediatrics, Family Medicine
- Place of Service:Office, Hospital, Laboratory, Genetics Clinic