What is the ICD10 (International Classification of Diseases, 10th Revision) code for a person undergoing a lipid test as part of a medical study?

ICD-10 Code for Lipid Testing in a Medical Study

The appropriate ICD-10 code for a person undergoing a lipid test as part of a medical study is Z00.6 (Encounter for examination for normal comparison and control in clinical research program).

Coding Rationale

When coding for laboratory tests performed specifically for research purposes, it's important to distinguish these encounters from routine clinical care. The Z00.6 code is specifically designed for:

• Participants in medical research studies
• Control subjects in clinical trials
• Examinations performed for comparison purposes in research

This code accurately reflects that the lipid testing is being performed as part of a research protocol rather than for diagnostic or treatment purposes.

Alternative Codes to Consider

While Z00.6 is the primary code to use, depending on the specific circumstances of the research study, you might consider these additional codes:

• Z13.220: Encounter for screening for lipoid disorders (if the research specifically involves lipid screening)
• Z00.00: Encounter for general adult medical examination without abnormal findings (if the lipid test is part of a comprehensive health assessment within the study)

Documentation Requirements

For proper coding of research-related laboratory tests:

1. Document clearly that the lipid test is being performed as part of a research study
2. Include the name or protocol number of the research study in the medical record
3. Note whether the participant is a case subject or control subject
4. Document that informed consent for the research has been obtained

Common Pitfalls to Avoid

• Don't use diagnostic codes for lipid disorders (E78.0-E78.9) unless the participant has a confirmed lipid disorder that is being treated
• Avoid using Z13.220 alone (screening for lipoid disorders) as this implies clinical care rather than research
• Don't use routine preventive visit codes (Z00.00-Z00.01) as the primary code since these represent standard clinical care

Billing Considerations

It's important to note that most insurance plans will not cover laboratory tests performed solely for research purposes. The research study budget typically covers these costs. Ensure that:

1. The laboratory requisition clearly indicates the test is for research purposes
2. The Z00.6 code is prominently displayed on all documentation
3. The research protocol number is included on the laboratory order

By using the Z00.6 code, you properly identify the encounter as research-related, which helps maintain accurate medical records and appropriate billing practices.