2024 ICD-10-CM Diagnosis Code Z11.52
Encounter for screening for COVID-19
- ICD-10-CM Code:
- Z11.52
- ICD-10 Code for:
- Encounter for screening for COVID-19
- Is Billable?
- Yes - Valid for Submission
- Code Navigator:
Z11.52 is a billable diagnosis code used to specify a medical diagnosis of encounter for screening for covid-19. The code is valid during the current fiscal year for the submission of HIPAA-covered transactions from October 01, 2023 through September 30, 2024. The code is exempt from present on admission (POA) reporting for inpatient admissions to general acute care hospitals.
This code describes a circumstance which influences the patient's health status but not a current illness or injury. The code is unacceptable as a principal diagnosis.
Clinical Classification
Clinical Category is Exposure, encounters, screening or contact with infectious disease
- CCSR Category Code: FAC016
- Inpatient Default CCSR: X - Not applicable.
- Outpatient Default CCSR: Y - Yes, default outpatient assignment for principal diagnosis or first-listed diagnosis.
Index to Diseases and Injuries References
The following annotation back-references for this diagnosis code are found in the injuries and diseases index. The Index to Diseases and Injuries is an alphabetical listing of medical terms, with each term mapped to one or more ICD-10-CM code(s).
- - Screening (for) - Z13.9
- - COVID-19 - Z11.52
- - disease or disorder - Z13.9
- - COVID-19 - Z11.52
- - SARS-CoV-2 - Z11.52
Code Edits
The Medicare Code Editor (MCE) detects and reports errors in the coding of claims data. The following ICD-10-CM Code Edits are applicable to this code:
- Unacceptable principal diagnosis - There are selected codes that describe a circumstance which influences an individual's health status but not a current illness or injury, or codes that are not specific manifestations but may be due to an underlying cause. These codes are considered unacceptable as a principal diagnosis.
Present on Admission (POA)
Z11.52 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 | Reason for Code | CMS will pay the CC/MCC DRG? |
|---|---|---|
| Y | Diagnosis was present at time of inpatient admission. | YES |
| N | Diagnosis was not present at time of inpatient admission. | NO |
| U | Documentation insufficient to determine if the condition was present at the time of inpatient admission. | NO |
| W | Clinically undetermined - unable to clinically determine whether the condition was present at the time of inpatient admission. | YES |
| 1 | Unreported/Not used - Exempt from POA reporting. | NO |
Replacement Code
Z1152 replaces the following previously assigned ICD-10-CM code(s):
- Z11.59 - Encounter for screening for other viral diseases
Patient Education
COVID-19 Testing
COVID-19 (coronavirus disease 2019) is a disease caused by a virus called SARS-CoV-2. There are two types of tests for this virus:
- A viral test tells you if you have a current infection. Viral tests can either be rapid tests or laboratory tests:
- Rapid tests can be done in minutes. They are often antigen tests, which look for specific proteins from the virus. Some rapid tests are self-tests which you can do at home.
- Laboratory tests can take days to complete and include PCR tests.
- An antibody (serology) test might tell you if you had a past infection.
If you need a COVID-19 test, you can:
- Buy a self-test online or at a store. Make sure that the test you buy has been authorized by the U.S. Food and Drug Administration (FDA).
- Check your state or local health department's website for information on testing in your area.
- Contact your health care provider.
Even if your COVID-19 viral test is negative (the test did not detect the virus), you should still take steps to protect yourself and others.
Centers for Disease Control and Prevention
[Learn More in MedlinePlus]
Code History
- FY 2024 - No Change, effective from 10/1/2023 through 9/30/2024
- FY 2023 - No Change, effective from 10/1/2022 through 9/30/2023
- FY 2022 - No Change, effective from 10/1/2021 through 9/30/2022