Z01.818: Encounter for other preprocedural examination

Z01.818, encounter for other preprocedural examination, is listed as a covered diagnosis in 10 Medicare billing and coding articles that apply to 46 HCPCS Level II codes, including A9500 (Technetium tc-99m sestamibi, diagnostic, per study dose), A9502 (Technetium tc-99m tetrofosmin, diagnostic, per study dose), A9505 (Thallium tl-201 thallous chloride, diagnostic, per…). The articles come from 5 Medicare contractors. A listed diagnosis supports medical necessity only; coverage still depends on the LCD's criteria and on documentation in the medical record.

HCPCS Level II codes with Z01.818 as a covered diagnosis

CodeDescriptionMedicare coverageDMEPOS fee 2026 (state range)Articles listing it
A9500Technetium tc-99m sestamibi, diagnostic, per study doseCarrier judgment—2
A9502Technetium tc-99m tetrofosmin, diagnostic, per study doseCarrier judgment—2
A9505Thallium tl-201 thallous chloride, diagnostic, per millicurieCarrier judgment—2
A9512Technetium tc-99m pertechnetate, diagnostic, per millicurieCarrier judgment—2
A9560Technetium tc-99m labeled red blood cells, diagnostic, per study dose, up to 30 millicuriesCarrier judgment—2
A9538Technetium tc-99m pyrophosphate, diagnostic, per study dose, up to 25 millicuriesCarrier judgment—2
A9501Technetium tc-99m teboroxime, diagnostic, per study doseCarrier judgment—2
J2785Injection, regadenoson, 0.1 mgCarrier judgment—3
J0153Injection, adenosine, 1 mg (not to be used to report any adenosine phosphate compounds)Special coverage instructions apply—3
J1250Injection, dobutamine hydrochloride, per 250 mgSpecial coverage instructions apply—3
J1245Injection, dipyridamole, per 10 mgSpecial coverage instructions apply—3
J3490Unclassified drugsSpecial coverage instructions apply—2
J0881Injection, darbepoetin alfa, 1 microgram (non-esrd use)Special coverage instructions apply—3
J0885Injection, epoetin alfa, (for non-esrd use), 1000 unitsSpecial coverage instructions apply—3
Q5106Injection, epoetin alfa-epbx, biosimilar, (retacrit) (for non-esrd use), 1000 unitsSpecial coverage instructions apply—3
J0882Injection, darbepoetin alfa, 1 microgram (for esrd on dialysis)Special coverage instructions apply—3
J0888Injection, epoetin beta, 1 microgram, (for non esrd use)Special coverage instructions apply—3
Q5105Injection, epoetin alfa-epbx, biosimilar, (retacrit) (for esrd on dialysis), 100 unitsSpecial coverage instructions apply—3
J0887Injection, epoetin beta, 1 microgram, (for esrd on dialysis)Special coverage instructions apply—3
J0890Injection, peginesatide, 0.1 mg (for esrd on dialysis)Carrier judgment—3
Q4081Injection, epoetin alfa, 100 units (for esrd on dialysis)Special coverage instructions apply—3
G0017Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies, other than the office setting); first 60 minutesCarrier judgment—2
G0018Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies, other than the office setting); each additional 30 minutes (list separately in addition to code for primary service)Carrier judgment—2
G0451Development testing, with interpretation and report, per standardized instrument formCarrier judgment—1
A9520Technetium tc-99m tilmanocept, diagnostic, up to 0.5 millicuriesCarrier judgment—1

21 more codes are listed. See every code with payment by region in Caduvo.

Medicare policy articles listing Z01.818

A diagnosis listed as covered in a billing and coding article supports medical necessity for the article's codes; it does not guarantee payment. Coverage depends on the LCD's criteria, the contractor's jurisdiction and documentation in the medical record.

Other Z01 diagnoses (Encounter for other special examination without complaint, suspected or reported diagnosis)

Frequently asked questions

Does Medicare cover Z01.818 (Encounter for other preprocedural examination)?

Medicare covers items and services, not diagnoses. 10 Medicare billing and coding articles list Z01.818 as a covered diagnosis for 46 HCPCS Level II codes: the diagnosis can support medical necessity for those codes, but payment still depends on the LCD's coverage criteria and the medical record.

Which HCPCS codes can be billed with ICD-10 Z01.818?

The Level II codes from the policies most specific to this diagnosis are A9500 (Technetium tc-99m sestamibi, diagnostic, per study dose, 2 articles); A9502 (Technetium tc-99m tetrofosmin, diagnostic, per study dose, 2 articles); A9505 (Thallium tl-201 thallous chloride, diagnostic, per…, 2 articles); A9512 (Technetium tc-99m pertechnetate, diagnostic, per millicurie, 2 articles); A9560 (Technetium tc-99m labeled red blood cells, diagnostic, per…, 2 articles). Code choice depends on the item supplied; check each code's descriptor.

Which Medicare policy articles list Z01.818?

A56494 (Billing and Coding: Cardiovascular Nuclear Medicine); A52866 (Billing and Coding: Speech-Language Pathology); A56743 (Billing and Coding: Cardiovascular Nuclear Medicine), and 7 more articles.

What is ICD-10-CM code Z01.818?

Z01.818 is the ICD-10-CM code for encounter for other preprocedural examination, in category Z01 (Encounter for other special examination without complaint, suspected or reported diagnosis), chapter 22: Factors influencing health status and contact with health services.

Next steps

Sources: CMS Medicare Coverage Database billing and coding articles (covered ICD-10 code lists and HCPCS links); ICD-10-CM FY2026; CMS HCPCS Level II release October 2026; CMS DMEPOS fee schedule 2026 (non-rural state fees). Not billing or legal advice.

Chapter 22: Factors influencing health status and contact with health services · All diagnoses · HCPCS lookup