Lab Review ICD-10-CM Codes

What ICD-10 codes are used for lab review?

In the medical field, several ICD-10 codes are commonly used to describe various clinical scenarios and conditions that may necessitate laboratory tests and analysis or other specified special examinations. These codes enable healthcare professionals to document and bill for services provided during lab reviews accurately. Here are the commonly used lab review ICD-10 codes, along with clinical descriptions for each code:

• R73.01 - Abnormal glucose: This code is used when a patient's blood glucose levels are outside the normal range, indicating potential issues such as diabetes or prediabetes, which often require further lab review and diagnostic testing. These abnormal findings may necessitate additional lab work for early detection of metabolic disorders.
• R74.0 - Abnormal serum enzyme levels: When lab test results show elevated or abnormal levels of serum enzymes, it can be a sign of various medical conditions, such as liver disease or muscle injury, necessitating further lab review for a precise diagnosis. Healthcare providers must identify the underlying cause of these test findings.
• R82.5 - Proteinuria: Proteinuria indicates an abnormal amount of protein in the urine, which can be a sign of kidney disease, among other conditions. Lab reviews are essential for determining the underlying cause.
• E03.9 - Hypothyroidism, unspecified: Hypothyroidism affecting the thyroid gland may require a lab review to diagnose the condition's severity and guide treatment decisions.
• R07.9 - Chest pain, unspecified: Lab tests may be conducted in chest pain cases to rule out severe cardiac conditions or to identify other causes, such as muscle strain or anxiety.
• N18.9 - Chronic kidney disease, unspecified: Lab review is crucial for diagnosing and staging chronic kidney disease, which can have various causes and complications.
• D72.829 - Eosinophilia, unspecified: Elevated eosinophil levels in blood tests can indicate various underlying conditions, including allergies, infections, or autoimmune diseases, requiring further investigation.
• R55 - Syncope and collapse: Lab work may be necessary to identify the underlying causes of syncope (fainting) and collapses resulting from heart issues, neurological problems, or other conditions.
• Z13.6 - Encounter for screening for cardiovascular disorders: This code is used when patients undergo lab reviews as part of routine cardiovascular screening, such as lipid profile testing, to assess their risk of heart disease.

Which lab review ICD codes are billable?

Determining whether specific lab review ICD-10 codes are billable depends on various factors, including the healthcare provider's documentation, the patient's insurance, and the particular circumstances of the lab review. 

However, here is a general indication of whether commonly used lab review ICD-10 codes are typically billable:

• R73.01 - Abnormal glucose: Yes
• R74.0 - Abnormal serum enzyme levels: Yes
• R82.5 - Proteinuria: Yes
• E03.9 - Hypothyroidism, unspecified: Yes
• R07.9 - Chest pain, unspecified: Yes
• N18.9 - Chronic kidney disease, unspecified: Yes
• D72.829 - Eosinophilia, unspecified: Yes
• R55 - Syncope and collapse: Yes
• Z13.6 - Encounter for screening for cardiovascular disorders: Yes

These ICD-10 codes are commonly used for billing, but the necessity, visit context, and insurance coverage affect billability. Accurate documentation is crucial to support billing, and insurance policies and patient coverage also impact the process.

Clinical information

• ICD-10-CM codes are crucial in accurately documenting and billing for various medical conditions requiring laboratory reviews and diagnostic testing. These codes provide a standardized way to describe clinical scenarios, ensuring proper classification and billing for the services offered during lab reviews.
• Lab reviews are often initiated when clinical symptoms, possible disease precursors, or other findings indicate the need for further investigation and assessment.
• Accurate and detailed documentation by healthcare providers is fundamental to support the medical necessity of lab reviews for billing purposes.
• The specific context of the patient's visit, the medical necessity of the lab review, and the patient's insurance coverage all influence whether a lab review is billable.
• Commonly used ICD-10 codes for lab review encompass a range of conditions, from abnormal glucose levels to chest pain, proteinuria, and chronic diseases.
• Labs ordered for screening purposes in seemingly well individuals may use different diagnosis codes than those ordered for diagnostic purposes.
• When patients test positive, results often require specific code assignment and follow-up examination. Test results showing abnormal findings may necessitate additional diagnostic tests for early detection of disease.
• Billing for lab reviews also depends on whether the review is part of routine screenings, diagnostic evaluations, or monitoring of chronic conditions.
• Insurance policies and the extent of patient coverage further impact the billing process and reimbursement for lab review services.
• Accurate coding and billing procedures ensure that healthcare providers can deliver quality care while efficiently managing their finances.
• A person consulting for preventive services may require encounter for screening codes rather than diagnostic codes.

Synonyms Include

• Laboratory Examination
• Diagnostic Analysis
• Clinical Testing
• Medical Assessment
• Pathology Evaluation

Synonyms include

• Laboratory examination
• Diagnostic analysis
• Clinical testing
• Medical assessment
• Pathology evaluation
• Lab work
• Special examinations
• Test findings review
• Laboratory tests analysis
• Diagnostic tests evaluation