2024 ICD-10-CM Diagnosis Code Z36.9
Encounter for antenatal screening, unspecified
- ICD-10-CM Code:
- Z36.9
- ICD-10 Code for:
- Encounter for antenatal screening, unspecified
- Is Billable?
- Yes - Valid for Submission
- Code Navigator:
Z36.9 is a billable diagnosis code used to specify a medical diagnosis of encounter for antenatal screening, unspecified. 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.
The code Z36.9 is applicable to female patients aged 12 through 55 years inclusive. It is clinically and virtually impossible to use this code on a non-female patient outside the stated age range.
Unspecified diagnosis codes like Z36.9 are acceptable when clinical information is unknown or not available about a particular condition. Although a more specific code is preferable, unspecified codes should be used when such codes most accurately reflect what is known about a patient's condition. Specific diagnosis codes should not be used if not supported by the patient's medical record.
Approximate Synonyms
The following clinical terms are approximate synonyms or lay terms that might be used to identify the correct diagnosis code:
- Increased nuchal translucency detected by multiple marker screening
- Rubella screening - blood sent
- Rubella screening status
- Trisomy 18 detected by multiple marker screening
Clinical Classification
Clinical Category is Antenatal screening
- CCSR Category Code: PRG001
- Inpatient Default CCSR: Y - Yes, default inpatient assignment for principal diagnosis or first-listed diagnosis.
- 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).
- - Antenatal
- - screening (encounter for) of mother - See Also: Encounter, antenatal screening; - Z36.9
- - Encounter (with health service) (for) - Z76.89
- - antenatal screening - Z36.9
- - placental sample (taken vaginally) - See Also: Encounter, antenatal screening; - Z36.9
- - Prenatal
- - screening of mother - See Also: Encounter, antenatal screening; - Z36.9
- - Screening (for) - Z13.9
- - antenatal, of mother - See Also: Encounter, antenatal screening; - Z36.9
- - prenatal, of mother - See Also: Encounter, antenatal screening; - Z36.9
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:
- Maternity diagnoses - The Medicare Code Editor detects inconsistencies in maternity cases by checking a patient's age and any diagnosis on the patient's record. The maternity code edits apply to patients age ange is 9–64 years inclusive (e.g., diabetes in pregnancy, antepartum pulmonary complication).
- Diagnoses for females only - The Medicare Code Editor detects inconsistencies between a patient’s sex and any diagnosis on the patient’s record, these edits apply to FEMALES only .
Present on Admission (POA)
Z36.9 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
Z369 replaces the following previously assigned ICD-10-CM code(s):
- Z36 - Encounter for antenatal screening of mother
Convert Z36.9 to ICD-9-CM
- ICD-9-CM Code: V28.9 - Antenatal screening NOS
Patient Education
Prenatal Testing
Prenatal testing provides information about your baby's health before he or she is born. Some routine tests during pregnancy also check on your health. At your first prenatal visit, your health care provider will test for a number of things, including problems with your blood, signs of infections, and whether you are immune to rubella (German measles) and chickenpox.
Throughout your pregnancy, your health care provider may suggest a number of other tests, too. Some tests are suggested for all women, such as screenings for gestational diabetes, Down syndrome, and HIV. Other tests might be offered based on your:
- Age
- Personal or family medical history
- Ethnic background
- Results of routine tests
There are two types of tests:
- Screening tests are tests that are done to see if you or your baby might have certain problems. They evaluate risk, but do not diagnose problems. If your screening test result is abnormal, it does not mean that there is a problem. It means that more information is needed. Your health care provider can explain what the test results mean and possible next steps. You may need diagnostic testing.
- Diagnostic tests show whether or not you or your baby have a certain problem.
It is your choice whether or not to get the prenatal tests. You and your health care provider can discuss the risks and benefits of the tests, and what kind of information the tests can give you. Then you can decide which ones are right for you.
Dept. of Health and Human Services Office on Women's Health
[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
- FY 2021 - No Change, effective from 10/1/2020 through 9/30/2021
- FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020
- FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
- FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018