Z51.81
Z51.81: Encounter for therapeutic drug level monitoring
Billable / specific codeICD-10-CMPOA exempt
Z51.81 is a billable, specific ICD-10-CM code for encounter for therapeutic drug level monitoring. It is valid for submission on a claim.
Check Z51.81 with the rest of the claim: free scrubberExcludes1: never code together
These conditions cannot occur together. Billing both on the same encounter is a denial.
- encounter for blood-drug test for administrative or medicolegal reasons (Z02.83)
Code also
Both codes may be needed to describe the encounter fully. Sequencing depends on the reason for the visit.
- any long-term (current) drug therapy (Z79.-)
Risk adjustment
No CMS-HCC V28 category: this code does not change a RAF score.
Medicare coverage
Z51.81 is named in 10 Medicare coverage policies: 10 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- A54799Billing and Coding: Urine Drug Testing
- A55001Billing and Coding: Urine Drug Testing
- A56494Billing and Coding: Cardiovascular Nuclear Medicine
- A56743Billing and Coding: Cardiovascular Nuclear Medicine
Alphabetic index entries that lead here
- Encounter›therapeutic drug level monitoring
- Monitoring›therapeutic drug level
Code history
Unchanged in every release from FY2024 to FY2027.