Z01.89: Encounter for other specified special examinations
Z01.89, encounter for other specified special examinations, is listed as a covered diagnosis in 8 Medicare billing and coding articles that apply to 30 HCPCS Level II codes, including J0461 (Injection, atropine sulfate, 0.01 mg), J0153 (Injection, adenosine, 1 mg (not to be used to report any…), J1250 (Injection, dobutamine hydrochloride, per 250 mg). The articles come from 4 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 Z01.89 as a covered diagnosis
| Code | Description | Medicare coverage | DMEPOS fee 2026 (state range) | Articles listing it |
|---|---|---|---|---|
| J0461 | Injection, atropine sulfate, 0.01 mg | Special coverage instructions apply | — | 5 |
| J0153 | Injection, adenosine, 1 mg (not to be used to report any adenosine phosphate compounds) | Special coverage instructions apply | — | 5 |
| J1250 | Injection, dobutamine hydrochloride, per 250 mg | Special coverage instructions apply | — | 5 |
| J0280 | Injection, aminophyllin, up to 250 mg | Special coverage instructions apply | — | 5 |
| J1245 | Injection, dipyridamole, per 10 mg | Special coverage instructions apply | — | 5 |
| C8925 | Transesophageal echocardiography (tee) with contrast, or without contrast followed by with contrast, real time with image documentation (2d) (with or without m-mode recording); including probe placement, image acquisition, interpretation and report | Special coverage instructions apply | — | 3 |
| C8926 | Transesophageal echocardiography (tee) with contrast, or without contrast followed by with contrast, for congenital cardiac anomalies; including probe placement, image acquisition, interpretation and report | Special coverage instructions apply | — | 3 |
| C8927 | Transesophageal echocardiography (tee) with contrast, or without contrast followed by with contrast, for monitoring purposes, including probe placement, real time 2-dimensional image acquisition and interpretation leading to ongoing (continuous) assessment of (dynamically changing) cardiac pumping function and to therapeutic measures on an immediate time basis | Special coverage instructions apply | — | 3 |
| Q9957 | Injection, perflutren lipid microspheres, per ml | Carrier judgment | — | 3 |
| Q9956 | Injection, octafluoropropane microspheres, per ml | Carrier judgment | — | 3 |
| Q9955 | Injection, perflexane lipid microspheres, per ml | Carrier judgment | — | 3 |
| A9700 | Supply of injectable contrast material for use in echocardiography, per study | Special coverage instructions apply | — | 3 |
| J2785 | Injection, regadenoson, 0.1 mg | Carrier judgment | — | 2 |
| C8921 | Transthoracic echocardiography with contrast, or without contrast followed by with contrast, for congenital cardiac anomalies; complete | Special coverage instructions apply | — | 2 |
| C8922 | Transthoracic echocardiography with contrast, or without contrast followed by with contrast, for congenital cardiac anomalies; follow-up or limited study | Special coverage instructions apply | — | 2 |
| C8923 | Transthoracic echocardiography with contrast, or without contrast followed by with contrast, real-time with image documentation (2d), includes m-mode recording, when performed, complete, without spectral or color doppler echocardiography | Special coverage instructions apply | — | 2 |
| C8924 | Transthoracic echocardiography with contrast, or without contrast followed by with contrast, real-time with image documentation (2d), includes m-mode recording, when performed, follow-up or limited study | Special coverage instructions apply | — | 2 |
| C8928 | Transthoracic echocardiography with contrast, or without contrast followed by with contrast, real-time with image documentation (2d), includes m-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or pharmacologically induced stress, with interpretation and report | Special coverage instructions apply | — | 2 |
| C8929 | Transthoracic echocardiography with contrast, or without contrast followed by with contrast, real-time with image documentation (2d), includes m-mode recording, when performed, complete, with spectral doppler echocardiography, and with color flow doppler echocardiography | Special coverage instructions apply | — | 2 |
| C8930 | Transthoracic echocardiography, with contrast, or without contrast followed by with contrast, real-time with image documentation (2d), includes m-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or pharmacologically induced stress, with interpretation and report; including performance of continuous electrocardiographic monitoring, with physician supervision | Special coverage instructions apply | — | 2 |
| A9500 | Technetium tc-99m sestamibi, diagnostic, per study dose | Carrier judgment | — | 1 |
| A9502 | Technetium tc-99m tetrofosmin, diagnostic, per study dose | Carrier judgment | — | 1 |
| A9555 | Rubidium rb-82, diagnostic, per study dose, up to 60 millicuries | Carrier judgment | — | 1 |
| A9505 | Thallium tl-201 thallous chloride, diagnostic, per millicurie | Carrier judgment | — | 1 |
| A9526 | Nitrogen n-13 ammonia, diagnostic, per study dose, up to 40 millicuries | Carrier judgment | — | 1 |
5 more codes are listed. See every code with payment by region in Caduvo.
Medicare policy articles listing Z01.89
- A56809: Billing and Coding: Transesophageal Echocardiography (TEE) (CGS Administrators, LLC (MAC - Part A, MAC - Part B); 3 Level II codes). LCD with the same title: L33579, L34337, L35016
- A56505: Billing and Coding: Transesophageal Echocardiography (TEE) (Novitas Solutions, Inc. (MAC - Part A, MAC - Part B); 6 Level II codes). LCD with the same title: L33579, L34337, L35016
- A56476: Billing and Coding: Cardiac Radionuclide Imaging (Palmetto GBA (MAC - Part A, MAC - Part B); 13 Level II codes). LCD with the same title: L33457
- A52868: Billing and Coding: Transesophageal Echocardiography (TEE) (Wellpoint Federal (MAC - Part A, MAC - Part B); 3 Level II codes). LCD with the same title: L33579, L34337, L35016
- A57306: Billing and Coding: Transthoracic Echocardiography (TTE) (CGS Administrators, LLC (MAC - Part A, MAC - Part B); 19 Level II codes). LCD with the same title: L33577, L34338
- A54768: Billing and Coding: Cardiac Blood Pool Imaging (Multiple Gated Acquisition Scanning- MUGA, Ventriculography) When Performed in Conjunction with Cardiotoxic Chemotherapy (Palmetto GBA (MAC - Part A, MAC - Part B); 5 Level II codes)
- A56781: Billing and Coding: Transthoracic Echocardiography (TTE) (Wellpoint Federal (MAC - Part A, MAC - Part B); 17 Level II codes). LCD with the same title: L33577, L34338
- A56625: Billing and Coding: Echocardiography (Palmetto GBA (MAC - Part A, MAC - Part B); 6 Level II codes). LCD with the same title: L37379
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)
- Z01.810 — Encounter for preprocedural cardiovascular examination
- Z01.818 — Encounter for other preprocedural examination
- Z01.82 — Encounter for allergy testing
- Z01.30 — Encounter for examination of blood pressure without abnormal findings
- Z01.31 — Encounter for examination of blood pressure with abnormal findings
Frequently asked questions
Does Medicare cover Z01.89 (Encounter for other specified special examinations)?
Medicare covers items and services, not diagnoses. 8 Medicare billing and coding articles list Z01.89 as a covered diagnosis for 30 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 Z01.89?
The Level II codes from the policies most specific to this diagnosis are J0461 (Injection, atropine sulfate, 0.01 mg, 5 articles); J0153 (Injection, adenosine, 1 mg (not to be used to report any…, 5 articles); J1250 (Injection, dobutamine hydrochloride, per 250 mg, 5 articles); J0280 (Injection, aminophyllin, up to 250 mg, 5 articles); J1245 (Injection, dipyridamole, per 10 mg, 5 articles). Code choice depends on the item supplied; check each code's descriptor.
Which Medicare policy articles list Z01.89?
A56809 (Billing and Coding: Transesophageal Echocardiography (TEE)); A56505 (Billing and Coding: Transesophageal Echocardiography (TEE)); A56476 (Billing and Coding: Cardiac Radionuclide Imaging), and 5 more articles.
What is ICD-10-CM code Z01.89?
Z01.89 is the ICD-10-CM code for encounter for other specified special examinations, 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
- Run a reimbursement report for a device billed under J0461
- Watch J0461 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J0461
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