ICD-10-CM Code Z13.5

Encounter for screening for eye and ear disorders

Version 2020 Billable Code Unacceptable Principal Diagnosis POA Exempt

Valid for Submission

Z13.5 is a billable code used to specify a medical diagnosis of encounter for screening for eye and ear disorders. The code is valid for the year 2020 for the submission of HIPAA-covered transactions. The ICD-10-CM code Z13.5 might also be used to specify conditions or terms like child hearing screening failure, child hearing screening failure referred to specialist, child hearing screening first failure, child hearing screening second failure, hearing screening status, suspected deafness, etc The code is exempt from present on admission (POA) reporting for inpatient admissions to general acute care hospitals.

The code Z13.5 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.

ICD-10:Z13.5
Short Description:Encounter for screening for eye and ear disorders
Long Description:Encounter for screening for eye and ear disorders

Tabular List of Diseases and Injuries

The Tabular List of Diseases and Injuries is a list of ICD-10 codes, organized "head to toe" into chapters and sections with guidance for inclusions, exclusions, descriptions and more. The following references are applicable to the code Z13.5:

Type 2 Excludes

Type 2 Excludes
A type 2 excludes note represents "Not included here". An excludes2 note indicates that the condition excluded is not part of the condition represented by the code, but a patient may have both conditions at the same time. When an Excludes2 note appears under a code, it is acceptable to use both the code and the excluded code together, when appropriate.
  • encounter for general hearing examination Z01.1
  • encounter for general vision examination Z01.0

Index to Diseases and Injuries

The Index to Diseases and Injuries is an alphabetical listing of medical terms, with each term mapped to one or more ICD-10 code(s). The following references for the code Z13.5 are found in the index:


Code Edits

The Medicare Code Editor (MCE) detects and reports errors in the coding of claims data. The following ICD-10 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.

Synonyms

The following clinical terms are approximate synonyms or lay terms that might be used to identify the correct diagnosis code:

  • Child hearing screening failure
  • Child hearing screening failure referred to specialist
  • Child hearing screening first failure
  • Child hearing screening second failure
  • Hearing screening status
  • Suspected deafness

Present on Admission (POA)

Z13.5 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 CodePOA Reason for CodeCMS will pay the CC/MCC DRG?
YDiagnosis was present at time of inpatient admission.YES
NDiagnosis was not present at time of inpatient admission.NO
UDocumentation insufficient to determine if the condition was present at the time of inpatient admission.NO
WClinically undetermined - unable to clinically determine whether the condition was present at the time of inpatient admission.YES
1Unreported/Not used - Exempt from POA reporting. NO

Convert Z13.5 to ICD-9

  • V80.1 - Screening for glaucoma (Approximate Flag)
  • V80.2 - Screening-eye cond NEC (Approximate Flag)
  • V80.3 - Screening for ear dis (Approximate Flag)

Code Classification

  • Factors influencing health status and contact with health services (Z00–Z99)
    • Persons encountering health services for examinations (Z00-Z13)
      • Encounter for screening for other diseases and disorders (Z13)

Code History

  • FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016
    (First year ICD-10-CM implemented into the HIPAA code set)
  • FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
  • FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
  • FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
  • FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020

Information for Patients


Ear Disorders

Your ear has three main parts: outer, middle and inner. You use all of them in hearing. Sound waves come in through your outer ear. They reach your middle ear, where they make your eardrum vibrate. The vibrations are transmitted through three tiny bones, called ossicles, in your middle ear. The vibrations travel to your inner ear, a snail-shaped organ. The inner ear makes the nerve impulses that are sent to the brain. Your brain recognizes them as sounds. The inner ear also controls balance.

A variety of conditions may affect your hearing or balance:

  • Ear infections are the most common illness in infants and young children.
  • Tinnitus, a roaring in your ears, can be the result of loud noises, medicines or a variety of other causes.
  • Meniere's disease may be the result of fluid problems in your inner ear; its symptoms include tinnitus and dizziness.
  • Ear barotrauma is an injury to your ear because of changes in barometric (air) or water pressure.

Some ear disorders can result in hearing disorders and deafness.


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Eye Diseases

Some eye problems are minor and don't last long. But some can lead to a permanent loss of vision.

Common eye problems include

  • Refractive errors
  • Cataracts - clouded lenses
  • Optic nerve disorders, including glaucoma
  • Retinal disorders - problems with the nerve layer at the back of the eye
  • Macular degeneration - a disease that destroys sharp, central vision
  • Diabetic eye problems
  • Conjunctivitis - an infection also known as pinkeye

Your best defense is to have regular checkups, because eye diseases do not always have symptoms. Early detection and treatment could prevent vision loss. See an eye care professional right away if you have a sudden change in vision, if everything looks dim, or if you see flashes of light. Other symptoms that need quick attention are pain, double vision, fluid coming from the eye, and inflammation.

NIH: National Eye Institute


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Health Screening

Screenings are tests that look for diseases before you have symptoms. Screening tests can find diseases early, when they're easier to treat. You can get some screenings in your doctor's office. Others need special equipment, so you may need to go to a different office or clinic.

Some conditions that doctors commonly screen for include

  • Breast cancer and cervical cancer in women
  • Colorectal cancer
  • Diabetes
  • High blood pressure
  • High cholesterol
  • Osteoporosis
  • Overweight and obesity
  • Prostate cancer in men

Which tests you need depends on your age, your sex, your family history, and whether you have risk factors for certain diseases. After a screening test, ask when you will get the results and whom to talk to about them.

Agency for Healthcare Research and Quality


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