2026 ICD-10-CM Diagnosis Code Z00.01Encounter for general adult medical examination with abnormal findings

ICD-10-CM Codes›Z00–Z99›Z00-Z13›Z00

ICD-10-CM Z00.01
CMSSource: CMS FY 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

Z00.01 is a billable ICD-10-CM diagnosis code for encounter for general adult medical examination with abnormal findings. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026). The code is restricted by the Medicare Code Editor to adult patients (age 15 through 124), not accepted as a principal diagnosis, and exempt from POA reporting. Coders also document this condition as abnormal wellness exam. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Medical examination/evaluation.

This medical diagnosis code is frequently used in Family Practice, Internal Medicine, and OB/GYN medical specialties to designate conditions such general medical examination.

Code Identity

ICD-10-CM Code
Z00.01
Billable Status
Yes — Valid for Submission
Code Describes
Encounter for general adult medical examination with abnormal findings
Short Description
Encounter for general adult medical exam w abnormal findings
Parent Code
Z00.0
Encounter for general adult medical examination

Code Classification

ChapterZ00–Z99Factors influencing health status and contact with health services
SectionZ00-Z13Persons encountering health services for examinations
CategoryZ00Encounter for general examination without complaint, suspected or reported diagnosis
This CodeZ00.01Encounter for general adult medical examination with abnormal findings

Code EditsBilling

Medicare Code Editor checks that affect claim validity for Z00.01.

Adult diagnoses
The Medicare Code Editor detects inconsistencies in adult cases by checking a patient's age and any diagnosis on the patient's record. The adult code edits apply to patients age range is 15–124 years inclusive (e.g., senile delirium, mature cataract).
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.

Present on Admission (POA)Billing

Z00.01 is exempt from POA reporting on inpatient claims to general acute care hospitals. Review other POA exempt codes.

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Abnormal wellness exam

Tabular List NotesGuidance

Coding notes and annotation back-references applicable to this code.

Use Additional Code

  • code to identify abnormal findings

Index to Diseases and InjuriesGuidance

Alphabetical index entries that point to this code.

External Cause of Injuries IndexGuidance

References for this code in the External Cause of Injuries Index.

    • Admission(for)
      • examination at health care facility (adult)
        • with abnormal findings
    • Encounter(with health service) (for)
      • laboratory (as part of a general medical examination)
        • with abnormal findings
    • Encounter(with health service) (for)
      • radiological (as part of a general medical examination)
        • with abnormal findings
    • Encounter(with health service) (for)
      • X-ray of chest (as part of a general medical examination)
        • with abnormal findings
    • Examination(for) (following) (general) (of) (routine)
      • with abnormal findings
    • Examination(for) (following) (general) (of) (routine)
      • annual (adult) (periodic) (physical)
        • with abnormal findings
    • Examination(for) (following) (general) (of) (routine)
      • laboratory (as part of a general medical examination)
        • with abnormal findings
    • Examination(for) (following) (general) (of) (routine)
      • medical (adult) (for) (of)
        • with abnormal findings
    • Examination(for) (following) (general) (of) (routine)
      • medical (adult) (for) (of)
        • general (adult)
          • with abnormal findings
    • Examination(for) (following) (general) (of) (routine)
      • periodic (adult) (annual) (routine)
        • with abnormal findings
    • Examination(for) (following) (general) (of) (routine)
      • radiological (as part of a general medical examination)
        • with abnormal findings
    • Test, tests, testing(for)
      • laboratory (as part of a general medical examination)
        • with abnormal finding
    • X-ray(of)
      • chest
        • routine (as part of a general medical examination)
          • with abnormal findings
    • X-ray(of)
      • routine (as part of a general medical examination)
        • with abnormal findings

Clinical ClassificationClinical

AHRQ’s CCSR groups this code into broader clinical categories.

CCSR FAC014
Medical examination/evaluation
Default principal diagnosis: inpatient No · outpatient Yes

Patient EducationClinical

Health Checkup

Regular checkups with your health care provider are different from appointments for sickness or injury. These checkups include physical exams as well as preventive care. Preventative care may include:

Read the full article at MedlinePlus

Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.

Convert Z00.01 to ICD-9-CMHistory

The closest ICD-9-CM equivalents under the General Equivalence Mappings.

ICD-9-CM
V70.0 Routine medical exam
Approximate The match is approximate rather than exact.

Code HistoryHistory

FY 2016AddedAdded to the ICD-10-CM code setEffective October 1, 2015, the first year of ICD-10-CM.
FY 2017–2025No changes
FY 2026CurrentCurrent code set, no changesEffective October 1, 2025 through September 30, 2026.

Questions About Z00.01Overview

Is Z00.01 (Encounter for general adult medical examination) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report encounter for general adult medical examination with abnormal findings on HIPAA-covered claims from October 1, 2025 through September 30, 2026.

Can Z00.01 be a principal diagnosis?

No. The Medicare Code Editor rejects this code as a principal diagnosis because encounter for general adult medical examination with abnormal findings describes a circumstance that influences health status rather than a current illness. Report it as a secondary diagnosis.

Who can Z00.01 be reported for?

The Medicare Code Editor checks encounter for general adult medical examination with abnormal findings against patient demographics: this code is intended for adult patients (age 15 through 124). Claims outside these limits are flagged as inconsistent.

Is Z00.01 exempt from POA reporting?

Yes. CMS lists this code among those exempt from present on admission reporting, so hospitals do not assign a POA indicator for encounter for general adult medical examination with abnormal findings on inpatient claims.

What is the ICD-9 equivalent of Z00.01?

Under the General Equivalence Mappings, encounter for general adult medical examination with abnormal findings converts to ICD-9-CM V70.0 (routine medical exam). The mapping is approximate, so confirm the match fits the documentation.