Cracking the Code

Coding Factors Influencing Health Status and Contact with Health Services

The ICD-10-CM codes for Factors Influencing Health Status and Contact with Health Services or “Z codes” are found in Chapter 21 of our FY2023 ICD-10-CM code book. These codes identify the reason why the patient is receiving services when a disease or disorder is not the reason the services are rendered.

“Z codes” are reported when the patient is not sick and presents for specific care such as a routine physical, or screening mammogram. These codes can also be used to identify contact/exposure, inoculation and vaccination status, and other statuses such as if a patient is a carrier of a disease or any personal or family history. Other identifications include screenings, observations, aftercare, follow-up, donor, and counseling. These codes can also be used in any healthcare setting. They can also be sequenced as either primary or secondary.

“Z codes” also identify when a patient presents for a routine exam. Examples include well-child preventative visits, routine gynecological exams, and preoperative clearance. Social determinants of health are also identified by “z codes”.  According to the Dept. of Health and Human Services (DHHS), “Social determinants of health (SDOH) are the conditions in the environments where people are born, live, learn, work, play, worship and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks.”

Q: True or False: When a patient presents for a screening test and the provider finds something abnormal, the Z code to identify the screening should be sequenced first.
A: True: According to the ICD-10-CM guidelines I.C.21,c.5, when a screening test is performed and an abnormality is found, sequence the Z code for the screening first, followed by an additional code to report the abnormal findings.
Reference: FY 2023 ICD-10-CM Coding Guidelines
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