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ICD-10 Guide
ICD-10 CodesZ13.22

Z13.22

Encounter for screening for metabolic disorder

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

Code Description

ICD-10 Z13.22 is a billable code used to indicate a diagnosis of encounter for screening for metabolic disorder.

Key Diagnostic Point:

Z13.22 is used to indicate an encounter for screening for metabolic disorders, which are conditions that disrupt normal metabolism, the process of converting food to energy on a cellular level. This screening is crucial for early detection and management of disorders such as diabetes, obesity, and dyslipidemia. Factors influencing health status include genetics, lifestyle choices, and environmental factors, which can all contribute to metabolic disorders. Social determinants of health, such as socioeconomic status, access to healthcare, and education, play a significant role in an individual's risk for these conditions. Preventive care through regular screenings can help identify at-risk individuals, allowing for timely interventions that can mitigate long-term health complications. Documentation must reflect the reason for the screening, any relevant patient history, and the results of the screening tests to ensure accurate coding and reimbursement.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Need for comprehensive patient history and risk factor assessment
  • Variability in screening protocols based on age and risk factors
  • Documentation of patient consent and understanding of screening purpose
  • Potential for co-morbid conditions that may complicate coding

Audit Risk Factors

  • Inadequate documentation of screening rationale
  • Failure to document patient consent for screening
  • Lack of follow-up documentation for abnormal results
  • Coding without supporting clinical evidence

Specialty Focus

Medical Specialties

Primary Care

Documentation Requirements

Documentation should include patient history, risk factors, and results of the screening tests. It is essential to note any referrals made for further evaluation.

Common Clinical Scenarios

Routine checkups where metabolic screening is indicated based on age or risk factors, follow-up visits for abnormal screening results.

Billing Considerations

Consideration of social determinants such as access to healthy food and exercise opportunities, which may influence metabolic health.

Public Health

Documentation Requirements

Documentation should focus on population health data, screening rates, and outcomes to track public health trends.

Common Clinical Scenarios

Community health screenings, epidemiological studies assessing metabolic disorder prevalence.

Billing Considerations

Emphasis on health equity and addressing barriers to screening in underserved populations.

Coding Guidelines

Inclusion Criteria

Use Z13.22 When
  • Z codes are used when a patient is not currently ill but is seeking care for preventive reasons
  • 22 should be sequenced appropriately, often as a secondary diagnosis when a primary condition is present
  • Payer requirements may vary, so it is essential to verify coverage for screening services

Exclusion Criteria

Do NOT use Z13.22 When
No specific exclusions found.

Related CPT Codes

80061CPT Code

Lipid panel

Clinical Scenario

Used during a screening visit for metabolic disorders to assess cholesterol levels.

Documentation Requirements

Document the reason for the lipid panel and any relevant patient history.

Specialty Considerations

Primary care providers should ensure that the lipid panel is part of a comprehensive metabolic screening.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for greater specificity in coding metabolic disorder screenings, improving data collection and health outcomes tracking.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for greater specificity in coding metabolic disorder screenings, improving data collection and health outcomes tracking.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for greater specificity in coding metabolic disorder screenings, improving data collection and health outcomes tracking.

Resources

Clinical References

  • •
    Preventive Services Task Force Recommendations

Coding & Billing References

  • •
    Preventive Services Task Force Recommendations

Frequently Asked Questions

When should Z13.22 be used?

Z13.22 should be used during encounters specifically for screening for metabolic disorders, particularly when no current diagnosis exists, and preventive measures are being taken.