Is Z01.811 a billable ICD-10-CM code?

Yes. Z01.811 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does Z01.811 sit in the tabular list?

Factors influencing health status and contact with health services (Z00-Z99), in the block Persons encountering health services for examinations (Z00-Z13).

What cannot be coded together with Z01.811?

Z01.811 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above Z01.811 (Z01) and apply to it just the same.

Z01.811

Z01.811 — Encounter for preprocedural respiratory examination

Billable / specific codeICD-10-CMPOA exempt

Z01.811 is a billable, specific ICD-10-CM code for encounter for preprocedural respiratory examination. It is valid for submission on a claim.

Excludes1 inherited from the categories above Z01.811

These are not written on Z01.811, but they bind it: a note on a category applies to every code beneath it. Billing Z01.811 with anything listed here is a denial.

Written on Z01 — Encounter for other special examination without complaint, suspected or reported diagnosis

encounter for examination for administrative purposes (Z02.-)
encounter for examination for suspected conditions, proven not to exist (Z03.-)
encounter for laboratory, radiologic and imaging examinations for sign(s) and symptom(s) - code to the sign(s) or symptom(s)

Excludes2 inherited from the categories above Z01.811

Also inherited, and the opposite of Excludes1: these conditions are not part of Z01.811, but a patient can have both, so you may code both.

Written on Z01 — Encounter for other special examination without complaint, suspected or reported diagnosis

encounter for laboratory and radiologic examinations as a component of general medical examinations (Z00.0-)
screening examinations (Z11-Z13)

Risk adjustment

Z01.811 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.

Medicare coverage

Z01.811 is named in 1 Medicare coverage policy — 1 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

A57326Billing and Coding: Electrocardiograms

How Z01.811 is indexed

Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to Z01.811.

Examination›pre-procedural›respiratory
Examination›medical›pre-procedural›respiratory

Code history

Z01.811 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.

Related codes at this level

Codes that share Z01.81. If Z01.811 is not quite right, the correct code is usually one of these.

Questions about Z01.811

Is Z01.811 a billable ICD-10-CM code?: Yes. Z01.811 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does Z01.811 sit in the tabular list?: Factors influencing health status and contact with health services (Z00-Z99), in the block Persons encountering health services for examinations (Z00-Z13).
What cannot be coded together with Z01.811?: Z01.811 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above Z01.811 (Z01) and apply to it just the same.