All PlansBilling CodesMedium impact
ICD-10 administrative examination diagnosis codes
Blue Cross Blue Shield of Rhode Island·RI·Physician / Facility
Effective date
Mar 1, 2020
We identified it
Jun 19, 2026
Summary
This policy clarifies proper use of ICD-10 Z02 administrative examination diagnosis codes, which must be used as the primary diagnosis when encounters are solely for administrative purposes like pre-employment exams, disability determinations, or insurance examinations. These administrative services are typically not covered by insurance.
Action Required
Immediately: Billing team must ensure Z02 administrative examination codes are used as primary diagnosis when encounters are solely for administrative purposes (pre-employment, disability determination, insurance exams, etc.). Update billing system to flag these codes as typically non-covered services. Train staff to use most specific Z02 code available and ensure all characters are coded to full length required.