2027 ICD-10-CM Diagnosis Code Z01.20Encounter for dental examination and cleaning without abnormal findings
Z01.20 is a billable ICD-10-CM diagnosis code for encounter for dental examination and cleaning without abnormal findings. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 951. The code is not accepted as a principal diagnosis by the Medicare Code Editor and exempt from POA reporting. Coders also document this condition as active tooth eruption. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Any dental condition including traumatic injury; Caries, periodontitis, and other preventable dental conditions; and Medical examination/evaluation.
Code Identity
Code Classification
Code EditsBilling
Medicare Code Editor checks that affect claim validity for Z01.20.
Present on Admission (POA)Billing
Z01.20 is exempt from POA reporting on inpatient claims to general acute care hospitals. Review the other POA exempt codes in Persons encountering health services for examinations (Z00-Z13).
Approximate SynonymsGuidance
Alternate terms and clinical phrases that map to this code.
- Active tooth eruption
- Dental caries-free
- Mobile tooth
- Normal mobility of tooth
- Tooth erupted
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to Z01.20: its own notes plus those printed at Z01, block Z00-Z13, and Chapter 21. A note printed at a category, block or chapter applies to every code under it.
Includes
Further defines, or gives examples of, the content of the category.
- routine examination of specific system
Applicable To
Conditions this code is used for: synonyms of the title or, for "other specified" codes, the conditions assigned to it. The list is not exhaustive.
- Encounter for dental examination and cleaning NOS
Excludes1
Not coded here: the excluded code is never reported together with this one, unless the two conditions are unrelated.
Excludes2
Not included here: the excluded condition is not part of this code, but a patient may have both, so both codes may be reported.
Notes
General instructions on how these codes are used.
- Codes from category Z01 represent the reason for the encounter. A separate procedure code is required to identify any examinations or procedures performed
- Z codes represent reasons for encounters. A corresponding procedure code must accompany a Z code if a procedure is performed. Categories Z00-Z99 are provided for occasions when circumstances other than a disease, injury or external cause classifiable to categories A00-Y89 are recorded as 'diagnoses' or 'problems'. This can arise in two main ways:
- (a) When a person who may or may not be sick encounters the health services for some specific purpose, such as to receive limited care or service for a current condition, to donate an organ or tissue, to receive prophylactic vaccination (immunization), or to discuss a problem which is in itself not a disease or injury.
- (b) When some circumstance or problem is present which influences the person's health status but is not in itself a current illness or injury.
Source: CMS ICD-10-CM Tabular List. How to read instructional notes.
Referenced in Other NotesGuidance
Instructional notes printed at other codes that name Z01.20, its category, or a range that includes it.
Excludes1 1
These codes carry an Excludes1 note naming Z01.20: they are not reported together with it, unless the two conditions are unrelated.
- Z02.7 Encounter for issue of medical certificate
Excludes2 1
These codes carry an Excludes2 note naming Z01.20: its condition is not part of those codes, and both may be reported when the patient has both.
Notes 1
These notes mention Z01.20.
Index to Diseases and InjuriesGuidance
Alphabetical index entries that point to this code.
Admission (for) See Also: Encounter (for);
examination at health care facility (adult) See Also: Examination; Z00.00
dental Z01.20
Dental See Also: condition;
examination Z01.20
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Patient EducationClinical
Dental Health
It's important to take care of your mouth and teeth starting in childhood. If you don't, you could have problems with your teeth and gums - like cavities or even tooth loss.
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert Z01.20 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About Z01.20Overview
Is Z01.20 (Encounter for dental examination and cleaning) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report encounter for dental examination and cleaning without abnormal findings on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What MS-DRG does Z01.20 group to?
On inpatient claims, encounter for dental examination and cleaning without abnormal findings maps to MS-DRG 951 (other Factors Influencing Health Status), which carries a relative weight of 0.5574. Higher weights mean higher Medicare reimbursement.
Can Z01.20 be a principal diagnosis?
No. The Medicare Code Editor rejects this code as a principal diagnosis because encounter for dental examination and cleaning without abnormal findings describes a circumstance that influences health status rather than a current illness. Report it as a secondary diagnosis.
Is Z01.20 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 dental examination and cleaning without abnormal findings on inpatient claims. The code appears in the Persons encountering health services for examinations (Z00-Z13) range of the CMS exempt list.
Can Z01.20 be reported with a code from Z02?
Not as a rule. The Excludes1 note at Z01, which applies to Z01.20, lists "encounter for examination for administrative purposes (Z02.-)". An Excludes1 note means the excluded code is never reported together with this one; the only exception is when the two conditions are unrelated to each other (Official Guidelines, Section I.A.12.a).