2026 ICD-10-CM Diagnosis Code Z04.41Encounter for examination and observation following alleged adult rape

ICD-10-CM CodesZ00–Z99Z00-Z13Z04

ICD-10-CM Z04.41
CMSSource: CMS FY 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

Z04.41 is a billable ICD-10-CM diagnosis code for encounter for examination and observation following alleged adult rape. 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). 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
Z04.41
Billable Status
Yes — Valid for Submission
Code Describes
Encounter for examination and observation following alleged adult rape
Short Description
Encounter for exam and obs following alleged adult rape
Parent Code
Encounter for examination and observation following alleged rape

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 CodeZ04.41Encounter for examination and observation following alleged adult rape

Code EditsBilling

Medicare Code Editor checks that affect claim validity for Z04.41.

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).

Tabular List NotesGuidance

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

Inclusion Terms

  • Suspected adult rape, ruled out
  • Suspected adult sexual abuse, ruled out

Index to Diseases and InjuriesGuidance

External Cause of Injuries IndexGuidance

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

    • Examination(for) (following) (general) (of) (routine)
      • alleged rape or sexual assault (victim), ruled out
        • adult
    • Observation(following) (for) (without need for further medical care)
      • alleged rape or sexual assault (victim), ruled out
        • adult
    • Rape
      • alleged, observation or examination, ruled out
        • adult

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

Sexual Assault

Sexual assault is any kind of sexual activity, contact, or experience that happens without your consent. That means the sexual activity happens even though you don't agree to it.

The full article covers:

  • What is sexual assault?
  • What does sexual assault include?
  • What does "consent" mean?
  • Who commits sexual assault?
  • What are the possible health effects from sexual assault?
  • What can I do if I'm a victim of sexual assault?
  • Can sexual assault be prevented?

Read the full article at MedlinePlus

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

Convert Z04.41 to ICD-9-CMHistory

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

ICD-9-CM
V71.5 Observ following rape
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 Z04.41Overview

Is Z04.41 a billable code?

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

Who can Z04.41 be reported for?

The Medicare Code Editor checks encounter for examination and observation following alleged adult rape against patient demographics: this code is intended for adult patients (age 15 through 124). Claims outside these limits are flagged as inconsistent.

What is the ICD-9 equivalent of Z04.41?

Under the General Equivalence Mappings, encounter for examination and observation following alleged adult rape converts to ICD-9-CM V71.5 (observ following rape). The mapping is approximate, so confirm the match fits the documentation.