2025 ICD-10-CM code Z51.81
(Active) Effective Date: N/A Factors influencing health status and contact with health services - Encounters for other specific health care 21 Feed
Encounter for therapeutic drug level monitoring.This code is used for encounters specifically for monitoring therapeutic drug levels.
Therapeutic drug level monitoring is medically necessary when the drug has a narrow therapeutic index, meaning there is a small difference between the effective dose and the toxic dose. It is also necessary when the patient's condition requires precise control of drug levels to achieve the desired therapeutic effect.
The physician or other healthcare professional is responsible for ordering the therapeutic drug level monitoring, reviewing the results, and adjusting the medication dosage as needed. They are also responsible for educating the patient about the importance of monitoring and any necessary precautions.
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- 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 a patient visits a healthcare provider to have their medication levels checked. This is usually done to make sure the medication is at the right level in the body to be effective and safe.
Encounter for therapeutic drug level monitoring. Code also any long-term (current) drug therapy (Z79.-). Excludes1: encounter for blood-drug test for administrative or medicolegal reasons (Z02.83).
Example 1: A patient with epilepsy is on long-term anticonvulsant medication and has their blood drawn to check the drug level and ensure it's within the therapeutic range., A patient receiving chemotherapy has their blood drawn regularly to monitor the levels of the chemotherapy drugs and adjust the dosage to minimize side effects and maximize effectiveness., A patient with a heart condition is taking digoxin and needs regular monitoring of digoxin levels to prevent toxicity.
Documentation should include the reason for the therapeutic drug monitoring, the name of the drug being monitored, the date and time of the blood draw, the test results, and any changes made to the medication regimen based on the results.
** This information is current as of November 30, 2024.Coding guidelines and regulations are subject to change. Always refer to the most current coding manuals and payer guidelines for the most accurate and up-to-date information.
- Payment Status: Active
- Specialties:Clinical pharmacology, oncology, cardiology, neurology, any specialty managing patients on long-term medications with a narrow therapeutic index.
- Place of Service:Office, Inpatient Hospital, On Campus-Outpatient Hospital, Off Campus-Outpatient Hospital, Independent Clinic, Federally Qualified Health Center