2026 ICD-10-CM Diagnosis Code Z29.81Encounter for HIV pre-exposure prophylaxis

ICD-10-CM Codes›Z00–Z99›Z20-Z29›Z29

ICD-10-CM Z29.81
CMSSource: CMS FY 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

Z29.81 is a billable ICD-10-CM diagnosis code for encounter for HIV pre-exposure prophylaxis. 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. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Encounter for prophylactic measures (excludes immunization).

Code Identity

ICD-10-CM Code
Z29.81
Billable Status
Yes — Valid for Submission
Code Describes
Encounter for HIV pre-exposure prophylaxis
Short Description
Encounter for HIV pre-exposure prophylaxis
Same as the full description in the CMS dataset.
Parent Code
Z29.8
Encounter for other specified prophylactic measures

Code Classification

ChapterZ00–Z99Factors influencing health status and contact with health services
SectionZ20-Z29Persons with potential health hazards related to communicable diseases
CategoryZ29Encounter for other prophylactic measures
This CodeZ29.81Encounter for HIV pre-exposure prophylaxis

Code EditsBilling

Medicare Code Editor checks that affect claim validity for Z29.81.

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)Billing

Z29.81 is exempt from POA reporting on inpatient claims to general acute care hospitals. Review other POA exempt codes.

Tabular List NotesGuidance

Coding notes and annotation back-references applicable to this code.

Code Also

  • , if applicable, risk factors for HIV, such as:
  • contact with and suspected exposure to human immunodeficiency virus HIV Z20.6
  • high risk sexual behavior Z72.5

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.

    • Encounter(with health service) (for)
      • HIV
        • pre-exposure prophylaxis
    • Encounter(with health service) (for)
      • HIV
        • PrEP
    • Encounter(with health service) (for)
      • prophylactic measures
        • HIV pre-exposure

Clinical ClassificationClinical

AHRQ’s CCSR groups this code into broader clinical categories.

CCSR FAC005
Encounter for prophylactic measures (excludes immunization)
Default principal diagnosis: inpatient No · outpatient Yes

Code History & ChangesHistory

Replacement Z29.81 replaces the following previously assigned code(s):

  • Z29.8 - Encounter for other specified prophylactic measures
FY 2024AddedAdded to the ICD-10-CM code setEffective October 1, 2023.
FY 2025No changes
FY 2026CurrentCurrent code set, no changesEffective October 1, 2025 through September 30, 2026.

Questions About Z29.81Overview

Is Z29.81 (Encounter for other specified prophylactic measures) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report encounter for HIV pre-exposure prophylaxis on HIPAA-covered claims from October 1, 2025 through September 30, 2026.

Can Z29.81 be a principal diagnosis?

No. The Medicare Code Editor rejects this code as a principal diagnosis because encounter for HIV pre-exposure prophylaxis describes a circumstance that influences health status rather than a current illness. Report it as a secondary diagnosis.

Is Z29.81 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 HIV pre-exposure prophylaxis on inpatient claims.