2026 ICD-10-CM Diagnosis Code Z04.2Encounter for examination and observation following work accident

ICD-10-CM Codes›Z00–Z99›Z00-Z13›Z04

ICD-10-CM Z04.2
CMSSource: CMS FY 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

Z04.2 is a billable ICD-10-CM diagnosis code for encounter for examination and observation following work accident. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026) and groups to MS-DRG 922 through 923. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Encounter for observation and examination for conditions ruled out (excludes infectious disease, neoplasm, mental disorders).

Code Identity

ICD-10-CM Code
Z04.2
Billable Status
Yes — Valid for Submission
Code Describes
Encounter for examination and observation following work accident
Short Description
Encounter for exam and observation following work accident
Parent Code
Z04
Encounter for examination and observation for other reasons

Code Classification

ChapterZ00–Z99Factors influencing health status and contact with health services
SectionZ00-Z13Persons encountering health services for examinations
CategoryZ04Encounter for examination and observation for other reasons
This CodeZ04.2Encounter for examination and observation following work accident

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.

    • Examination(for) (following) (general) (of) (routine)
      • following
        • accident NEC
          • work
    • Observation(following) (for) (without need for further medical care)
      • accident NEC
        • at work
    • Observation(following) (for) (without need for further medical care)
      • following work accident
    • Observation(following) (for) (without need for further medical care)
      • suspected, ruled out
        • accident at work

Clinical ClassificationClinical

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

CCSR FAC003
Encounter for observation and examination for conditions ruled out (excludes infectious disease, neoplasm, mental disorders)
Default principal diagnosis: inpatient Yes · outpatient Yes

Patient EducationClinical

Occupational Health

Occupational health problems occur at work or because of the kind of work you do. These problems can include:

Read the full article at MedlinePlus

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

Convert Z04.2 to ICD-9-CMHistory

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

ICD-9-CM
V71.3 Observ-work accident
Exact Match The mapping is direct, with no qualifiers.

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 Z04.2Overview

Is Z04.2 (Encounter for examination and observation for other reasons) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report encounter for examination and observation following work accident on HIPAA-covered claims from October 1, 2025 through September 30, 2026.

What MS-DRG does Z04.2 group to?

When encounter for examination and observation following work accident is the principal diagnosis on an inpatient stay, it groups to MS-DRG 922, 923, with relative weights from 1.0177 to 1.7494 depending on complications. Higher weights mean higher Medicare reimbursement.

What is the ICD-9 equivalent of Z04.2?

Under the General Equivalence Mappings, encounter for examination and observation following work accident converts to ICD-9-CM V71.3 (observ-work accident). The mapping is a direct match.