2024 ICD-10-CM Diagnosis Code Z36.85

Encounter for antenatal screening for Streptococcus B

ICD-10-CM Code:
Z36.85
ICD-10 Code for:
Encounter for antenatal screening for Streptococcus B
Is Billable?
Yes - Valid for Submission
Code Navigator:

Code Classification

  • Factors influencing health status and contact with health services
    (Z00–Z99)
    • Persons encountering health services in circumstances related to reproduction
      (Z30-Z39)
      • Encounter for antenatal screening of mother
        (Z36)

Z36.85 is a billable diagnosis code used to specify a medical diagnosis of encounter for antenatal screening for streptococcus b. 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.

The code Z36.85 is applicable to female patients aged 12 through 55 years inclusive. It is clinically and virtually impossible to use this code on a non-female patient outside the stated age range.

Clinical Classification

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).

Code Edits

The Medicare Code Editor (MCE) detects and reports errors in the coding of claims data. The following ICD-10-CM Code Edits are applicable to this code:

  • Maternity diagnoses - The Medicare Code Editor detects inconsistencies in maternity cases by checking a patient's age and any diagnosis on the patient's record. The maternity code edits apply to patients age ange is 9–64 years inclusive (e.g., diabetes in pregnancy, antepartum pulmonary complication).
  • Diagnoses for females only - The Medicare Code Editor detects inconsistencies between a patient’s sex and any diagnosis on the patient’s record, these edits apply to FEMALES only .

Present on Admission (POA)

Z36.85 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 IndicatorReason for CodeCMS will pay the CC/MCC DRG?
YDiagnosis was present at time of inpatient admission.YES
NDiagnosis was not present at time of inpatient admission.NO
UDocumentation insufficient to determine if the condition was present at the time of inpatient admission.NO
WClinically undetermined - unable to clinically determine whether the condition was present at the time of inpatient admission.YES
1Unreported/Not used - Exempt from POA reporting. NO

Replacement Code

Z3685 replaces the following previously assigned ICD-10-CM code(s):

  • Z36 - Encounter for antenatal screening of mother

Convert Z36.85 to ICD-9-CM

  • ICD-9-CM Code: V28.6 - Antenatal screen strep b

Patient Education


Strep B Test

What is a group B strep test?

Strep B, also known as group B strep (GBS), is a type of bacteria commonly found in the digestive tract, urinary tract, and genital area. It rarely causes symptoms or problems in adults but can be deadly to newborns.

In women, GBS is mostly found in the vagina and rectum. So a pregnant woman who is infected can pass the bacteria to her baby during labor and delivery. GBS can cause pneumonia, meningitis, and other serious illnesses in a baby. GBS infections are the leading cause of death and disability in newborns.

A group B strep test checks for GBS bacteria. If the test shows that a pregnant woman has GBS, she can take antibiotics during labor to protect her baby from infection.

Other names: group B streptococcus, group B beta-hemolytic streptococcus, streptococcus agalactiae, beta-hemolytic strep culture

What is it used for?

A group B strep test is most often used to look for GBS bacteria in pregnant women. Most pregnant women are tested as part of routine prenatal screening. It may also be used to test infants who show signs of infection.

Why do I need a group B strep test?

You may need a strep B test if you are pregnant. The American College of Obstetricians and Gynecologists recommends GBS testing for all pregnant women. Testing is usually done in the 36th or 37th week of pregnancy. If you go into labor earlier than 36 weeks, you may be tested at that time.

A baby may need a group B strep test if he or she has symptoms of infection. These include:

  • High fever
  • Trouble with feeding
  • Trouble breathing
  • Lack of energy (hard to wake up)

What happens during a group B strep test?

If you are pregnant, your health care provider may order a swab test or a urine test.

For a swab test, you will lie on your back on an exam table. Your health care provider will use a small cotton swab to take a sample of cells and fluids from your vagina and rectum.

For a urine test, you will most likely be told to use the "clean catch method" to ensure your sample is sterile. It includes the following steps.

  • Wash your hands.
  • Clean your genital area with a cleansing pad given to you by your provider. To clean, open your labia and wipe from front to back.
  • Start to urinate into the toilet.
  • Move the collection container under your urine stream.
  • Collect at least an ounce or two of urine into the container, which should have markings to indicate the amounts.
  • Finish urinating into the toilet.
  • Return the sample container as instructed by your health care provider.

If your baby needs testing, a provider may do a blood test or a spinal tap.

For a blood test, a health care professional will use a small needle to take a blood sample from your baby's heel. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. Your baby may feel a little sting when the needle goes in or out.

A spinal tap, also known as a lumbar puncture, is a test that collects and looks at spinal fluid, the clear liquid that surrounds the brain and spinal cord. During the procedure:

  • A nurse or other health care provider will hold your baby in a curled-up position.
  • A health care provider will clean your baby's back and inject an anesthetic into the skin, so your baby won't feel pain during the procedure. The provider may put a numbing cream on your baby's back before this injection.
  • The provider may also give your baby a sedative and/or pain reliever to help him or her better tolerate the procedure.
  • Once the area on the back is completely numb, your provider will insert a thin, hollow needle between two vertebrae in the lower spine. Vertebrae are the small backbones that make up the spine.
  • The provider will withdraw a small amount of cerebrospinal fluid for testing. This will take about five minutes.

Will I need to do anything to prepare for the test?

You don't any special preparations for group B strep tests.

Are there any risks to the test?

There is no risk to you from a swab or urine test. Your baby may have slight pain or bruising after a blood test, but that should go away quickly. Your baby will likely feel some pain after a spinal tap, but that shouldn't last too long. There is also a small risk of infection or bleeding after a spinal tap.

What do the results mean?

If you are pregnant and results show you have GBS bacteria, you will be given antibiotics intravenously (directly to your veins) during labor, at least four hours before delivery. This will prevent you from passing the bacteria to your baby. Taking antibiotics earlier in your pregnancy is not effective, because the bacteria can grow back very quickly. It's also more effective to take antibiotics through your vein, rather than by mouth.

You may not need antibiotics if you are having a planned delivery by Cesarean section (C-section). During a C-section, a baby is delivered through the mother's abdomen rather than vaginally. But you still should be tested during pregnancy because you may go into labor before your scheduled C-section.

If your baby's results show a GBS infection, he or she will be treated with antibiotics. If your provider suspects a GBS infection, he or she may treat your baby before test results are available. This is because GBS can cause serious illness or death.

If you have questions about your results or your baby's results, talk to your health care provider.

Learn more about laboratory tests, reference ranges, and understanding results.

Is there anything else I need to know about a group B strep test?

Strep B is one type of strep bacteria. Other forms of strep cause different types of infections. These include strep A, which causes strep throat, and streptococcus pneumoniae, which causes the most common type of pneumonia. Streptococcus pneumonia bacteria can also cause infections of the ear, sinuses, and bloodstream.

References

  1. ACOG: The American College of Obstetricians and Gynecologists [Internet]. Washington D.C.: American College of Obstetricians and Gynecologists; c2019. Group B Strep and Pregnancy; 2019 Jul [cited 2019 Nov 15]; [about 3 screens]. Available from: https://www.acog.org/Patients/FAQs/Group-B-Strep-and-Pregnancy
  2. Centers for Disease Control and Prevention [Internet]. Atlanta: U.S. Department of Health and Human Services; Group B Strep (GBS): Prevention; [cited 2019 Nov 15]; [about 4 screens]. Available from: https://www.cdc.gov/groupbstrep/about/prevention.html
  3. Centers for Disease Control and Prevention [Internet]. Atlanta: U.S. Department of Health and Human Services; Group B Strep (GBS): Signs and Symptoms; [cited 2019 Nov 15]; [about 4 screens]. Available from: https://www.cdc.gov/groupbstrep/about/symptoms.html
  4. Centers for Disease Control and Prevention [Internet]. Atlanta: U.S. Department of Health and Human Services; Streptococcus Laboratory: Streptococcus pneumoniae; [cited 2019 Nov 15]; [about 3 screens]. Available from: https://www.cdc.gov/streplab/pneumococcus/index.html
  5. Centers for Disease Control and Prevention [Internet]. Atlanta: U.S. Department of Health and Human Services; Travelers' Health: Pneumococcal Disease; [updated 2014 Aug 5; cited 2019 Nov 15]; [about 3 screens]. Available from: https://wwwnc.cdc.gov/travel/diseases/pneumococcal-disease-streptococcus-pneumoniae
  6. Intermountain Healthcare: Primary Children's Hospital [Internet]. Salt Lake City: Intermountain Healthcare; c2019. Lumbar Puncture in a Newborn; [cited 2019 Nov 15]; [about 4 screens]. Available from: https://intermountainhealthcare.org/ext/Dcmnt?ncid=520190573
  7. Lab Tests Online [Internet]. Washington D.C.: American Association for Clinical Chemistry; c2001–2019. Blood Culture; [updated 2019 Sep 23; cited 2019 Nov 15]; [about 2 screens]. Available from: https://labtestsonline.org/tests/blood-culture
  8. Lab Tests Online [Internet]. Washington D.C.: American Association for Clinical Chemistry; c2001–2019. Prenatal Group B Strep (GBS) Screening; [updated 2019 May 6; cited 2019 Nov 15]; [about 2 screens]. Available from: https://labtestsonline.org/tests/prenatal-group-b-strep-gbs-screening
  9. Lab Tests Online [Internet]. Washington D.C.: American Association for Clinical Chemistry; c2001–2019. Urine Culture; [updated 2019 Sep 18; cited 2019 Nov 15]; [about 2 screens]. Available from: https://labtestsonline.org/tests/urine-culture
  10. Michigan Medicine: University of Michigan [Internet]. Ann Arbor (MI): Regents of the University of Michigan; c1995–2021. Group B Streptococcal Infections in Newborns[cited 2021 Aug 6]; [about 3 screens]. Available from: https://www.uofmhealth.org/health-library/zp3014spec
  11. University of Rochester Medical Center [Internet]. Rochester (NY): University of Rochester Medical Center; c2019. Health Encyclopedia: Group B Streptococcus Infection in Babies; [cited 2019 Nov 15]; [about 2 screens]. Available from: https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=90&contentid=P02363
  12. University of Rochester Medical Center [Internet]. Rochester (NY): University of Rochester Medical Center; c2019. Health Encyclopedia: Pneumonia; [cited 2019 Nov 15]; [about 2 screens]. Available from: https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=85&contentid=P01321
  13. WHO Guidelines on Drawing Blood: Best Practices in Phlebotomy [Internet]. Geneva (SUI): World Health Organization; c2010. 6. Paediatric and neonatal blood sampling; [cited 2019 Nov 15]; [about 3 screens]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK138647

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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