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ICD-10 Guide
ICD-10 CodesZ13.79

Z13.79

Encounter for other screening for genetic and chromosomal anomalies

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

Code Description

ICD-10 Z13.79 is a billable code used to indicate a diagnosis of encounter for other screening for genetic and chromosomal anomalies.

Key Diagnostic Point:

Z13.79 is utilized during encounters specifically aimed at screening for genetic and chromosomal anomalies that do not fall under more specific categories. This code is crucial in preventive healthcare, allowing for early detection of potential genetic disorders, which can significantly influence health outcomes. Social determinants of health, such as socioeconomic status, education, and access to healthcare, play a vital role in the utilization of this screening. Patients may seek these screenings due to family history, personal health concerns, or as part of routine preventive care. The code is applicable in various settings, including outpatient clinics and public health initiatives, where genetic counseling and screening are offered. Proper documentation is essential to justify the use of this code, ensuring that the reasons for screening are clearly articulated, including any relevant social factors that may influence the patient's health status.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Need for comprehensive patient history to justify screening
  • Variability in genetic testing protocols and guidelines
  • Documentation of social determinants influencing health decisions
  • Potential overlap with other Z codes for genetic screening

Audit Risk Factors

  • Inadequate documentation supporting the need for screening
  • Failure to link screening to a specific clinical indication
  • Misuse of the code for non-preventive encounters
  • Inconsistent application of screening guidelines

Specialty Focus

Medical Specialties

Primary Care

Documentation Requirements

Documentation should include patient history, reason for screening, and any relevant family history of genetic disorders.

Common Clinical Scenarios

Routine checkups where genetic screening is discussed, referrals for genetic counseling, and follow-up visits post-screening.

Billing Considerations

Consideration of social determinants such as access to genetic counseling services and patient education on genetic risks.

Public Health

Documentation Requirements

Population-level data collection, including demographics and health outcomes related to genetic screening.

Common Clinical Scenarios

Community health initiatives aimed at increasing awareness of genetic disorders and screening programs.

Billing Considerations

Focus on health equity and access to screening services for underserved populations.

Coding Guidelines

Inclusion Criteria

Use Z13.79 When
  • Z codes are used primarily as secondary diagnoses to indicate encounters for preventive services
  • When coding Z13
  • 79, it should be sequenced appropriately based on the primary diagnosis
  • Payer requirements may vary, so it's essential to verify coverage for genetic screening services

Exclusion Criteria

Do NOT use Z13.79 When
No specific exclusions found.

Related CPT Codes

81200CPT Code

Genetic testing for specific mutations

Clinical Scenario

Used in conjunction with Z13.79 when a specific genetic test is performed following screening.

Documentation Requirements

Documentation must include the reason for the test and any relevant patient history.

Specialty Considerations

Primary care providers should ensure they are aware of the latest genetic testing guidelines.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for greater specificity in coding genetic screenings, enabling better tracking of health outcomes and resource allocation for preventive services.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for greater specificity in coding genetic screenings, enabling better tracking of health outcomes and resource allocation for preventive services.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for greater specificity in coding genetic screenings, enabling better tracking of health outcomes and resource allocation for preventive services.

Resources

Clinical References

  • •
    Genetic Screening Guidelines

Coding & Billing References

  • •
    Genetic Screening Guidelines

Frequently Asked Questions

When should Z13.79 be used?

Z13.79 should be used during encounters specifically for screening for genetic and chromosomal anomalies when there is no more specific Z code applicable. Documentation must support the need for screening based on clinical indications or social determinants.