Pathology/Lab Coding Alert

Question: A physician ordered a lead test as part of a pre-adoption examination for a 3-year-old child. How should we code this?

Codify Subscriber

Answer: The lab test code for lead is 83655 (Lead) in the chemistry section. If the only information you have about the reason for the test is as a screening for adoption services, you can report the diagnosis code as Z02.82 (Encounter for adoption services).

But if the physician indicates that he's ordering the test because of suspected lead exposure, or because of symptoms or a condition possibly related to lead exposure, you should list one of the following codes, asappropriate:

• Z77.011 (Contact with and (suspected) exposure to lead)
• Z13.88 (Encounter for screening for disorder due to exposure to contaminants).

If the lead test returns positive in a symptomatic patient, the most specific diagnosis is one of the codes in the range T56.0- (Toxic effects of lead and its compounds). A complete code would indicate the means of contamination (such as accidental) in the fifth digit, and the encounter (such as initial) in the seventh digit position.