2026 ICD-10-CM Diagnosis Code Z04.81Encounter for examination and observation of victim following forced sexual exploitation

ICD-10-CM Codes›Z00–Z99›Z00-Z13›Z04

ICD-10-CM Z04.81
CMSSource: CMS FY 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

Z04.81 is a billable ICD-10-CM diagnosis code for encounter for examination and observation of victim following forced sexual exploitation. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026). The code is exempt from POA reporting. 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
Z04.81
Billable Status
Yes — Valid for Submission
Code Describes
Encounter for examination and observation of victim following forced sexual exploitation
Short Description
Enctr for exam and obs of victim fol forced sex exploitation
Parent Code
Z04.8
Encounter for examination and observation for other specified 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 CodeZ04.81Encounter for examination and observation of victim following forced sexual exploitation

Present on Admission (POA)Billing

Z04.81 is exempt from POA reporting on inpatient claims to general acute care hospitals. Review other POA exempt codes.

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)
      • forced sexual exploitation
    • Examination(for) (following) (general) (of) (routine)
      • medicolegal reason NEC
        • following
          • forced sexual exploitation
    • Observation(following) (for) (without need for further medical care)
      • forced sexual exploitation

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.

Code History & ChangesHistory

Replacement Z04.81 replaces the following previously assigned code(s):

  • Z04.8 - Encounter for examination and observation for oth reasons
FY 2019AddedAdded to the ICD-10-CM code setEffective October 1, 2018.
FY 2020–2025No changes
FY 2026CurrentCurrent code set, no changesEffective October 1, 2025 through September 30, 2026.

Questions About Z04.81Overview

Is Z04.81 a billable code?

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

Is Z04.81 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 examination and observation of victim following forced sexual exploitation on inpatient claims.