2024 ICD-10-CM Diagnosis Code Z03.6
Encounter for observation for suspected toxic effect from ingested substance ruled out
- ICD-10-CM Code:
- Z03.6
- ICD-10 Code for:
- Encntr for obs for susp toxic eff from ingest sub ruled out
- Is Billable?
- Yes - Valid for Submission
- Code Navigator:
Z03.6 is a billable diagnosis code used to specify a medical diagnosis of encounter for observation for suspected toxic effect from ingested substance ruled out. The code is valid during the current fiscal year for the submission of HIPAA-covered transactions from October 01, 2023 through September 30, 2024. The code is exempt from present on admission (POA) reporting for inpatient admissions to general acute care hospitals.
Clinical Classification
Clinical Category is Encounter for observation and examination for conditions ruled out (excludes infectious disease, neoplasm, mental disorders)
- CCSR Category Code: FAC003
- Inpatient Default CCSR: Y - Yes, default inpatient assignment for principal diagnosis or first-listed diagnosis.
- Outpatient Default CCSR: Y - Yes, default outpatient assignment for principal diagnosis or first-listed diagnosis.
Tabular List of Diseases and Injuries
The following annotation back-references are applicable to this diagnosis code. The Tabular List of Diseases and Injuries is a list of ICD-10-CM codes, organized "head to toe" into chapters and sections with coding notes and guidance for inclusions, exclusions, descriptions and more.
Inclusion Terms
Inclusion TermsThese terms are the conditions for which that code is to be used. The terms may be synonyms of the code title, or, in the case of "other specified" codes, the terms are a list of the various conditions assigned to that code. The inclusion terms are not necessarily exhaustive. Additional terms found only in the Alphabetic Index may also be assigned to a code.
- Encounter for observation for suspected adverse effect from drug
- Encounter for observation for suspected poisoning
Index to Diseases and Injuries References
The following annotation back-references for this diagnosis code are found in the injuries and diseases index. The Index to Diseases and Injuries is an alphabetical listing of medical terms, with each term mapped to one or more ICD-10-CM code(s).
- - Observation (following) (for) (without need for further medical care) - Z04.9
- - adverse effect of drug - Z03.6
- - suicide attempt, alleged NEC - Z03.89
- - self-poisoning - Z03.6
- - suspected, ruled out - See Also: Suspected condition, ruled out;
- - drug poisoning or adverse effect - Z03.6
- - suicide attempt, alleged - Z03.89
- - self-poisoning - Z03.6
- - toxic effects from ingested substance (drug) (poison) - Z03.6
- - toxic effects from ingested substance (drug) (poison) - Z03.6
Present on Admission (POA)
Z03.6 is exempt from POA reporting - The Present on Admission (POA) indicator is used for diagnosis codes included in claims involving inpatient admissions to general acute care hospitals. POA indicators must be reported to CMS on each claim to facilitate the grouping of diagnoses codes into the proper Diagnostic Related Groups (DRG). CMS publishes a listing of specific diagnosis codes that are exempt from the POA reporting requirement. Review other POA exempt codes here.
CMS POA Indicator Options and Definitions
POA Indicator | Reason for Code | CMS will pay the CC/MCC DRG? |
---|---|---|
Y | Diagnosis was present at time of inpatient admission. | YES |
N | Diagnosis was not present at time of inpatient admission. | NO |
U | Documentation insufficient to determine if the condition was present at the time of inpatient admission. | NO |
W | Clinically undetermined - unable to clinically determine whether the condition was present at the time of inpatient admission. | YES |
1 | Unreported/Not used - Exempt from POA reporting. | NO |
Convert Z03.6 to ICD-9-CM
- ICD-9-CM Code: V71.89 - Observ-suspect cond NEC
Approximate Flag - The approximate mapping means there is not an exact match between the ICD-10 and ICD-9 codes and the mapped code is not a precise representation of the original code.
Code History
- FY 2024 - No Change, effective from 10/1/2023 through 9/30/2024
- FY 2023 - No Change, effective from 10/1/2022 through 9/30/2023
- FY 2022 - No Change, effective from 10/1/2021 through 9/30/2022
- FY 2021 - No Change, effective from 10/1/2020 through 9/30/2021
- FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020
- FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
- FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
- FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
- FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016. This was the first year ICD-10-CM was implemented into the HIPAA code set.