2025 ICD-10-CM code Z44.01
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Reason for encounter - Encounters for other specific health care Factors influencing health status and contact with health services Feed
Encounter for fitting and adjustment of a complete artificial arm.
Modifiers may be applicable depending on the circumstances of the visit and the specific payer's requirements.Consult appropriate payer resources.
Medical necessity is established by demonstrating the need for the fitting and adjustment to maintain or improve the patient's function and comfort.A change in the limb's size, shape, or a report of discomfort are typical reasons.Documentation must support that the adjustments made are clinically necessary.
The clinical responsibility typically falls to a prosthetist or orthotist.A physician may be involved in the overall care plan, but the fitting and adjustment are generally handled by a specialist in prosthetics.
- Factors influencing health status and contact with health services
- Z44.01 is under the broader category Z44 (Encounter for fitting and adjustment of external prosthetic device), which itself falls under the larger grouping of Z40-Z53 (Encounters for other specific health care).
In simple words: This code means the patient visited the doctor to get their artificial arm adjusted or fitted properly.This is separate from any other medical issue or treatment.
This ICD-10-CM code signifies a patient encounter specifically for the fitting and adjustment of a complete artificial arm.This code is used when a patient presents for the purpose of having their prosthetic arm adjusted or fitted, and no other significant medical issue or treatment is provided.It is important to note that if other procedures or diagnoses are present, they should be coded separately.The adjustment or fitting may involve alterations to the prosthetic device to improve comfort, function, or fit.The code does not encompass situations where the primary reason for the visit is a malfunction or complication of the device itself.
Example 1: A patient presents for their scheduled three-month check-up following the initial fitting of their new artificial arm. The prosthetist makes minor adjustments for optimal comfort and function., A patient experiences discomfort and limited range of motion with their artificial arm after an injury to their residual limb. They visit the prosthetist who re-evaluates the fit and makes modifications accordingly. , A patient's residual limb has changed shape and size resulting in poor fit of their artificial arm.The patient returns for re-evaluation and adjustment of their prosthesis.
Documentation should include the reason for the visit, the type and details of the prosthetic arm (complete, type of materials, etc.), the adjustments made by the prosthetist, and the patient's response to the adjustments.Pre- and post-adjustment measurements or assessments may be necessary for proper justification of the code.
** This code should be used in conjunction with procedure codes reflecting the actions performed during the adjustment.The physician's role in managing the overall patient care plan should be documented separately. Always refer to the most up-to-date coding guidelines for correct application of this code.The laterality (left or right) might be specified in additional documentation, though not explicitly required within the code itself.
- Revenue Code: Revenue codes will depend on the specific payer and the services provided.Consult your payer's specific guidelines.
- RVU: RVUs will vary based on factors such as geographic location, facility type, and payer contracts. Consult the appropriate fee schedules for the specific location and payer.
- Global Days: Not applicable. This is a fitting and adjustment visit, not a global procedure.
- Payment Status: Active
- Modifier TC rule: Not applicable.
- Fee Schedule: Historical fee schedule data varies significantly by payer and location. Consult relevant fee schedules.
- Specialties:Prosthetics and Orthotics, Physical Medicine and Rehabilitation
- Place of Service:Office, Outpatient Hospital, Prosthetics and Orthotics Clinic