ICD-10-CM Code Z03.6

Encounter for observation for suspected toxic effect from ingested substance ruled out

Version 2020 Billable Code POA Exempt

Valid for Submission

Z03.6 is a billable code used to specify a medical diagnosis of encounter for observation for suspected toxic effect from ingested substance ruled out. The code is valid for the year 2020 for the submission of HIPAA-covered transactions. The ICD-10-CM code Z03.6 might also be used to specify conditions or terms like accidental ingestion of potentially harmful entity or suspected alcohol abuse or suspected food poisoning or suspected poisoning. The code is exempt from present on admission (POA) reporting for inpatient admissions to general acute care hospitals.

ICD-10:Z03.6
Short Description:Encntr for obs for susp toxic eff from ingest sub ruled out
Long Description:Encounter for observation for suspected toxic effect from ingested substance ruled out

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 Z03.6:

Inclusion Terms

Inclusion Terms
These 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

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 Z03.6 are found in the index:


Synonyms

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

  • Accidental ingestion of potentially harmful entity
  • Suspected alcohol abuse
  • Suspected food poisoning
  • Suspected poisoning

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 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 Z03.6 to ICD-9

  • V71.89 - Observ-suspect cond NEC (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 medical obs for susp diseases and cond ruled out (Z03)

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