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v1.0.0
ICD-10 Guide
ICD-10 CodesZ01.811

Z01.811

Encounter for preprocedural respiratory examination

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/12/2025

Code Description

ICD-10 Z01.811 is a billable code used to indicate a diagnosis of encounter for preprocedural respiratory examination.

Key Diagnostic Point:

Z01.811 is used to document encounters specifically for preprocedural respiratory examinations, which are critical in assessing a patient's respiratory health prior to undergoing surgical or procedural interventions. This examination helps identify any underlying respiratory conditions that may complicate anesthesia or surgical outcomes. Factors influencing health status, such as smoking history, occupational exposures, and comorbidities like asthma or COPD, are evaluated during this encounter. Social determinants of health, including access to healthcare, socioeconomic status, and environmental factors, play a significant role in respiratory health and must be considered in the assessment. Preventive care is emphasized, as early identification of respiratory issues can lead to better management and outcomes. Screening for conditions like sleep apnea or chronic respiratory diseases may also be part of this encounter, ensuring comprehensive care and aftercare planning.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Need for thorough documentation of respiratory history and examination findings
  • Integration of social determinants of health into the assessment
  • Potential for multiple comorbidities affecting respiratory health
  • Variability in payer requirements for preprocedural examinations

Audit Risk Factors

  • Inadequate documentation of respiratory examination findings
  • Failure to link the encounter to a specific procedure
  • Lack of evidence for the necessity of the examination
  • Inconsistent coding practices across providers

Specialty Focus

Medical Specialties

Primary Care

Documentation Requirements

Comprehensive documentation of patient history, physical examination, and any relevant diagnostic tests.

Common Clinical Scenarios

Routine preoperative assessments, management of chronic respiratory conditions, and preventive screenings.

Billing Considerations

Consideration of social determinants such as smoking status, occupational exposures, and access to care.

Public Health

Documentation Requirements

Data collection for population health assessments and surveillance of respiratory health trends.

Common Clinical Scenarios

Community health screenings, epidemiological studies, and preventive health initiatives.

Billing Considerations

Focus on health disparities and access to preventive services.

Coding Guidelines

Inclusion Criteria

Use Z01.811 When
  • Z codes are used when a patient encounters healthcare services for reasons other than a current illness or injury
  • 811 should be sequenced appropriately, often as a secondary code following a primary diagnosis related to the procedure
  • Payer requirements may vary, so it's essential to verify specific guidelines

Exclusion Criteria

Do NOT use Z01.811 When
No specific exclusions found.

Related CPT Codes

94010CPT Code

Spirometry

Clinical Scenario

Used during the respiratory examination to assess lung function.

Documentation Requirements

Document the results of spirometry and any relevant findings.

Specialty Considerations

Primary care providers should ensure spirometry is performed in accordance with guidelines.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for greater specificity in coding encounters like Z01.811, enabling better tracking of respiratory health and associated risks in preprocedural settings.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for greater specificity in coding encounters like Z01.811, enabling better tracking of respiratory health and associated risks in preprocedural settings.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for greater specificity in coding encounters like Z01.811, enabling better tracking of respiratory health and associated risks in preprocedural settings.

Resources

Clinical References

  • •
    CDC Guidelines for Respiratory Health

Coding & Billing References

  • •
    CDC Guidelines for Respiratory Health

Frequently Asked Questions

What documentation is required for Z01.811?

Documentation must include a detailed respiratory history, examination findings, and any relevant diagnostic tests. It should also address social determinants of health that may impact respiratory status.