Rely on Descriptor to Evaluate Appropriateness of Code
Question: A primary care provider performed an echocardiogram (EKG) in-office to see whether a patient had any cardiac issues that would make a new medication unsuitable before submitting a prescription to the patient’s preferred pharmacy. Can I use Z01.810 to report this? AAPC Forum Participant Answer: According to the information you’ve provided, ICD-10-CM code Z01.810 (Encounter for preprocedural cardiovascular examination) wouldn’t be appropriate in this situation because the patient’s provider is not considering surgery or another procedure for treatment. This code is usually used to report an encounter that is part of a cardiovascular examination to make sure a patient can withstand a procedure, like a patient with osteoarthritis in the knee who is being scheduled for a knee arthroplasty. For this situation, you’re better off reporting Z51.81 (Encounter for therapeutic drug level monitoring), which shows that the point of the encounter was to evaluate whether a medication was biologically appropriate for a patient. AAPC’s Codify says there’s a Code also note to include “any long-term (current) drug therapy (Z79.-).” Rachel Dorrell, MA, MS, CPC-A, CPPM, Production Editor, AAPC
