2025 ICD-10-CM code Z49.31
Encounter for adequacy testing for hemodialysis.
Medical necessity for this code is established when a patient receiving hemodialysis requires assessment of the effectiveness of their treatment. This may be due to new onset of dialysis, changing clinical status, or suspected inadequate dialysis.
The physician or other healthcare provider performing and interpreting the hemodialysis adequacy testing is responsible for using this code.
- 21. Factors influencing health status and contact with health services (Z00-Z99)
- Encounters for other specific health care (Z40-Z53)
In simple words: This code is used when you visit a healthcare provider to check if your hemodialysis treatment is working properly.
This code is used for encounters specifically for the testing of the adequacy of hemodialysis treatment.It covers situations where a patient receiving hemodialysis undergoes specific tests to assess the effectiveness and sufficiency of their dialysis treatment.
Example 1: A patient with end-stage renal disease receiving chronic hemodialysis undergoes blood tests and other assessments to evaluate the adequacy of their current dialysis prescription., A patient new to hemodialysis undergoes adequacy testing to establish the optimal dialysis parameters., A patient experiencing symptoms of inadequate dialysis (e.g., fatigue, fluid overload) is seen for adequacy testing to adjust their treatment plan.
Documentation should support the medical necessity of the adequacy testing, such as the results of the tests performed (e.g., urea reduction ratio (URR), Kt/V) and any changes made to the dialysis prescription based on the test results.
** This code is exempt from the Present on Admission (POA) reporting requirement.
- Specialties:Nephrology
- Place of Service:Outpatient Hospital; Inpatient Hospital; Independent Clinic; Federally Qualified Health Center; End-Stage Renal Disease Treatment Facility