2026 ICD-10-CM Diagnosis Code Z13.5Encounter for screening for eye and ear disorders
Z13.5 is a billable ICD-10-CM diagnosis code for encounter for screening for eye and ear disorders. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026). The code is not accepted as a principal diagnosis by the Medicare Code Editor and exempt from POA reporting. Coders also document this condition as child hearing screening failure. 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
Code Classification
Code EditsBilling
Medicare Code Editor checks that affect claim validity for Z13.5.
Present on Admission (POA)Billing
Z13.5 is exempt from POA reporting on inpatient claims to general acute care hospitals. Review other POA exempt codes.
Approximate SynonymsGuidance
Alternate terms and clinical phrases that map to this 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
Tabular List NotesGuidance
Coding notes and annotation back-references applicable to this code.
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.
Index to Diseases and InjuriesGuidance
Alphabetical index entries that point to this code.
- Screening (for) - Z13.9
- cataract - Z13.5
- eye disorder - Z13.5
- glaucoma - Z13.5
External Cause of Injuries IndexGuidance
References for this code in the External Cause of Injuries Index.
- Screening(for)
- cataract
- Screening(for)
- congenital
- eye disorder
- Screening(for)
- disease or disorder
- ear
- Screening(for)
- disease or disorder
- eye
- Screening(for)
- glaucoma
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Patient EducationClinical
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.
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert Z13.5 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About Z13.5Overview
Is Z13.5 (Encounter for screening for other diseases and disorders) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report encounter for screening for eye and ear disorders on HIPAA-covered claims from October 1, 2025 through September 30, 2026.
Can Z13.5 be a principal diagnosis?
No. The Medicare Code Editor rejects this code as a principal diagnosis because encounter for screening for eye and ear disorders describes a circumstance that influences health status rather than a current illness. Report it as a secondary diagnosis.
Is Z13.5 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 eye and ear disorders on inpatient claims.
What is the ICD-9 equivalent of Z13.5?
Under the General Equivalence Mappings, encounter for screening for eye and ear disorders converts to ICD-9-CM V80.1 (screening for glaucoma), V80.2 (screening-eye cond NEC), and V80.3 (screening for ear dis). The mapping is approximate, so confirm the match fits the documentation.
