ICD-10-CM Code Z00.121

Encounter for routine child health examination with abnormal findings

Version 2020 Billable Code Pediatric Diagnoses Unacceptable Principal Diagnosis POA Exempt Pediatrics

Valid for Submission

Z00.121 is a billable code used to specify a medical diagnosis of encounter for routine child health examination with abnormal findings. The code is valid for the year 2020 for the submission of HIPAA-covered transactions. The ICD-10-CM code Z00.121 might also be used to specify conditions or terms like 1 year examination abnormal - for observation, 1 year examination abnormal - on treatment, 1 year examination abnormal - referred, 10 day examination abnormal - for observation, 10 day examination abnormal - on treatment, 10 year examination abnormal - for observation, etc The code is exempt from present on admission (POA) reporting for inpatient admissions to general acute care hospitals.

The code Z00.121 is applicable for patients aged 0 through 17 years inclusive. It is clinically and virtually impossible to use this code on a patient outside the stated age range.

The code is commonly used in pediatrics medical specialties to specify clinical concepts such as routine child health examination.

ICD-10:Z00.121
Short Description:Encounter for routine child health exam w abnormal findings
Long Description:Encounter for routine child health examination with abnormal findings

Tabular List of Diseases and Injuries

The Tabular List of Diseases and Injuries is a list of ICD-10 codes, organized "head to toe" into chapters and sections with guidance for inclusions, exclusions, descriptions and more. The following references are applicable to the code Z00.121:

Use Additional Code

Use Additional Code
The “use additional code” indicates that a secondary code could be used to further specify the patient’s condition. This note is not mandatory and is only used if enough information is available to assign an additional code.
  • code to identify abnormal findings

Index to Diseases and Injuries

The Index to Diseases and Injuries is an alphabetical listing of medical terms, with each term mapped to one or more ICD-10 code(s). The following references for the code Z00.121 are found in the index:


Code Edits

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

  • Pediatric diagnoses - Pediatric. Age range is 0–17 years inclusive (e.g., Reye’s syndrome, routine child health exam).
  • Unacceptable principal diagnosis - There are selected codes that describe a circumstance which influences an individual’s health status but not a current illness or injury, or codes that are not specific manifestations but may be due to an underlying cause. These codes are considered unacceptable as a principal diagnosis.

Synonyms

The following clinical terms are approximate synonyms or lay terms that might be used to identify the correct diagnosis code:

  • 1 year examination abnormal - for observation
  • 1 year examination abnormal - on treatment
  • 1 year examination abnormal - referred
  • 10 day examination abnormal - for observation
  • 10 day examination abnormal - on treatment
  • 10 year examination abnormal - for observation
  • 10 year examination abnormal - on treatment
  • 10 year examination abnormal - referred
  • 15 year examination abnormal - for observation
  • 15 year examination abnormal - on treatment
  • 15 year examination abnormal - referred
  • 18 month examination abnormal - for observation
  • 18 month examination abnormal - on treatment
  • 18 month examination abnormal - referred
  • 2.5 year examination abnormal - for observation
  • 2.5 year examination abnormal - on treatment
  • 2.5 year examination abnormal - referred
  • 3.5 year examination abnormal - for observation
  • 3.5 year examination abnormal - on treatment
  • 3.5 year examination abnormal - referred
  • 4.5 year examination abnormal - for observation
  • 4.5 year examination abnormal - on treatment
  • 4.5 year examination abnormal - referred
  • 6 week examination abnormal - for observation
  • 6 week examination abnormal - on treatment
  • 6 week examination abnormal - referred
  • 8 month examination abnormal - for observation
  • 8 month examination abnormal - on treatment
  • 8 month examination abnormal - referred
  • 8 week examination abnormal - for observation
  • 8 week examination abnormal - on treatment
  • 8 week examination abnormal - referred
  • 8-9 month examination abnormal - for observation
  • 8-9 month examination abnormal - on treatment
  • 8-9 month examination abnormal - referred
  • Child 21 month examination abnormal - for observation
  • Child 21 month examination abnormal - on treatment
  • Child 21 month examination abnormal: refer
  • Child 3 year exam abnormal - for observation
  • Child 3 year exam abnormal - on treatment
  • Child 3 year exam abnormal - referred
  • Child 39 month examination abnormal - for observation
  • Child 39 month examination abnormal - on treatment
  • Child 39 month examination abnormal - referred
  • Child 6 month examination abnormal - for observation
  • Child 6 month examination abnormal - on treatment
  • Child 6 month examination abnormal - referred
  • Child 7 month examination abnormal - on treatment
  • Child 7 month examination abnormal - referred
  • Seen by pediatric neurologist
  • Seen by pediatric oncologist
  • Seen by pediatrician
  • Seen by pediatrician

Present on Admission (POA)

Z00.121 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 CodePOA Reason 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

Convert Z00.121 to ICD-9

  • V20.2 - Routin child health exam (Approximate Flag)

Code Classification

  • Factors influencing health status and contact with health services (Z00–Z99)
    • Persons encountering health services for examinations (Z00-Z13)
      • Encntr for general exam w/o complaint, susp or reprtd dx (Z00)

Code History

  • FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016
    (First year ICD-10-CM implemented into the HIPAA code set)
  • FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
  • FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
  • FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
  • FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020

Information for Patients


Health Checkup

Regular health exams and tests can help find problems before they start. They also can help find problems early, when your chances for treatment and cure are better. Which exams and screenings you need depends on your age, health and family history, and lifestyle choices such as what you eat, how active you are, and whether you smoke.

To make the most of your next check-up, here are some things to do before you go:

  • Review your family medical history
  • Find out if you are due for any general screenings or vaccinations
  • Write down a list of issues and questions to take with you

Centers for Disease Control and Prevention


[Learn More]