Is Z01.812 a billable ICD-10-CM code?

Yes. Z01.812 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does Z01.812 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 Z01.812?

Z01.812 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 Z01.812 (Z01) and apply to it just the same.

Z01.812

Z01.812 — Encounter for preprocedural laboratory examination

Billable / specific codeICD-10-CMPOA exempt

Z01.812 is a billable, specific ICD-10-CM code for encounter for preprocedural laboratory examination. It is valid for submission on a claim.

Inclusion terms

Alternative wordings a physician may use in the chart for this same code.

Blood and urine tests prior to treatment or procedure

Excludes1 inherited from the categories above Z01.812

These are not written on Z01.812, but they bind it: a note on a category applies to every code beneath it. Billing Z01.812 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 Z01.812

Also inherited, and the opposite of Excludes1: these conditions are not part of Z01.812, 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

Z01.812 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

Z01.812 is named in 2 Medicare coverage policies — 1 listing it as supporting medical necessity, and 1 listing it as NOT covered. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

A52379Billing and Coding: CPT Code 87641 (Infectious agent detection by nucleic acid (DNA or RNA); Staphylococcus aureus, methicillin resistant, amplified probe technique)not covered
A57326Billing and Coding: Electrocardiograms

How Z01.812 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 Z01.812.

Examination›laboratory›preprocedural
Examination›pre-procedural›laboratory

Code history

Z01.812 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 Z01.812 is not quite right, the correct code is usually one of these.

Questions about Z01.812

Is Z01.812 a billable ICD-10-CM code?: Yes. Z01.812 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does Z01.812 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 Z01.812?: Z01.812 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 Z01.812 (Z01) and apply to it just the same.