Z Codes That May be Principal/First-Listed Diagnosis

Published 02/23/2018

Z codes are for use in any healthcare setting. Z codes may be used as either a first-listed (principal diagnosis code in the inpatient setting) or secondary code, depending on the circumstances of the encounter. Certain Z codes may only be used as first-listed or principal diagnosis. For example, there are three observation Z code categories for use in very limited circumstances.

Z Codes indicate a reason for an encounter and are not procedure codes. A corresponding procedure code must accompany a Z code to describe any procedure performed.  For further information, you may refer to ICD-10-CM Official Guidelines for Coding and Reporting, FY 2018 (PDF).

Z Codes That May be Principal/First-Listed Diagnosis
Z codes are a special group of codes provided in ICD-10-CM for the reporting of factors influencing health status and contact with health services. Z codes are designated as the principal/first listed diagnosis in specific situations such as:
  • To indicate that a person with a resolving disease, injury or chronic condition is being seen for specific aftercare
  • To indicate that a person is seen for the sole purpose of special therapy, such as chemotherapy, immunotherapy and radiation therapy
  • To indicate that a person not currently ill is encountering the health service for a specific reason, such as to act as an organ donor, encounter for medical observation for suspected diseases and conditions ruled out, administrative examinations (pre-employment exam, recruitment to armed forces), plastic and reconstructive surgery following medical procedures or healed injury (breast reconstruction following mastectomy)
  • To indicate the birth status of newborns
Examples

Z00      Encounter for general examination without complaint, suspected or reported diagnosis

   Except: Z00.6

Z01         Encounter for other special examination without complaint, suspected or reported diagnosis

Z02         Encounter for administrative examination

Z03         Encounter for medical observation for suspected diseases and conditions ruled out

Z04         Encounter for examination and observation for other reasons

Z33.2     Encounter for elective termination of pregnancy

Z31.81    Encounter for male factor infertility in female patient

Z31.83  Encounter for assisted reproductive fertility procedure cycle

Z31.84  Encounter for fertility preservation procedure

Z34         Encounter for supervision of normal pregnancy

Z39         Encounter for maternal postpartum care and examination

Z38         Liveborn infants according to place of birth and type of delivery

Z40         Encounter for prophylactic surgery

Z42         Encounter for plastic and reconstructive surgery following medical procedure or healed injury

Z51.0   Encounter for antineoplastic radiation therapy

Z51.1-     Encounter for antineoplastic chemotherapy and immunotherapy

Z52         Donors of organs and tissues

   Except: Z52.9, Donor of unspecified organ or tissue

Z76.1     Encounter for health supervision and care of foundling

Z76.2    Encounter for health supervision and care of other healthy infant and child

Z99.12  Encounter for respirator [ventilator] dependence during power failure


Was this article helpful?