2027 ICD-10-CM Diagnosis Code Z11.4Encounter for screening for human immunodeficiency virus [HIV]
Z11.4 is a billable ICD-10-CM diagnosis code for encounter for screening for human immunodeficiency virus [HIV]. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 951. The code is not accepted as a principal diagnosis by the Medicare Code Editor and exempt from POA reporting. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Exposure, encounters, screening or contact with infectious disease.
Code Identity
Code Classification
Code EditsBilling
Medicare Code Editor checks that affect claim validity for Z11.4.
Present on Admission (POA)Billing
Z11.4 is exempt from POA reporting on inpatient claims to general acute care hospitals. Review the other POA exempt codes in Persons encountering health services for examinations (Z00-Z13).
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to Z11.4: its own notes plus those printed at Z11, block Z00-Z13, and Chapter 21. A note printed at a category, block or chapter applies to every code under it.
Excludes1
Not coded here: the excluded code is never reported together with this one, unless the two conditions are unrelated.
- encounter for diagnostic examination-code to sign or symptom
Excludes2
Not included here: the excluded condition is not part of this code, but a patient may have both, so both codes may be reported.
Notes
General instructions on how these codes are used.
- Z codes represent reasons for encounters. A corresponding procedure code must accompany a Z code if a procedure is performed. Categories Z00-Z99 are provided for occasions when circumstances other than a disease, injury or external cause classifiable to categories A00-Y89 are recorded as 'diagnoses' or 'problems'. This can arise in two main ways:
- (a) When a person who may or may not be sick encounters the health services for some specific purpose, such as to receive limited care or service for a current condition, to donate an organ or tissue, to receive prophylactic vaccination (immunization), or to discuss a problem which is in itself not a disease or injury.
- (b) When some circumstance or problem is present which influences the person's health status but is not in itself a current illness or injury.
Source: CMS ICD-10-CM Tabular List. How to read instructional notes.
Referenced in Other NotesGuidance
Instructional notes printed at other codes that name Z11.4, its category, or a range that includes it.
Excludes2 3
These codes carry an Excludes2 note naming Z11.4: its condition is not part of those codes, and both may be reported when the patient has both.
- Z11.3 Encounter for screening for infections with a predominantly sexual mode of transmissionencounter for screening for human immunodeficiency virus [HIV] (Z11.4)
- Z00 Encounter for general examination without complaint, suspected or reported diagnosis
- Z01 Encounter for other special examination without complaint, suspected or reported diagnosis
Index to Diseases and InjuriesGuidance
Alphabetical index entries that point to this code.
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Patient EducationClinical
HIV Screening Test
An HIV test checks a sample of your blood, saliva (spit), or urine (pee) to see whether you are infected with HIV (human immunodeficiency virus). HIV is a virus that destroys certain cells in your immune system. These cells protect your body against diseases from germs, such as bacteria, viruses, and fungi.
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert Z11.4 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About Z11.4Overview
What is the ICD-10 code for encounter for screening for human immunodeficiency virus [HIV]?
The ICD-10-CM code for encounter for screening for human immunodeficiency virus [HIV] is Z11.4 (sometimes written as Z114). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
Is Z11.4 a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report encounter for screening for human immunodeficiency virus [HIV] on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What MS-DRG does Z11.4 group to?
On inpatient claims, encounter for screening for human immunodeficiency virus [HIV] maps to MS-DRG 951 (other Factors Influencing Health Status), which carries a relative weight of 0.5574. Higher weights mean higher Medicare reimbursement.
Can Z11.4 be a principal diagnosis?
No. The Medicare Code Editor rejects this code as a principal diagnosis because encounter for screening for human immunodeficiency virus [HIV] describes a circumstance that influences health status rather than a current illness. Report it as a secondary diagnosis.
Is Z11.4 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 screening for human immunodeficiency virus [HIV] on inpatient claims. The code appears in the Persons encountering health services for examinations (Z00-Z13) range of the CMS exempt list.
