ICD-10-CM Code Z36.9

Encounter for antenatal screening, unspecified

Version 2020 Billable Code Maternity Diagnoses Diagnoses For Females Only POA Exempt

Valid for Submission

Z36.9 is a billable code used to specify a medical diagnosis of encounter for antenatal screening, unspecified. The code is valid for the year 2020 for the submission of HIPAA-covered transactions. The ICD-10-CM code Z36.9 might also be used to specify conditions or terms like multiple marker screen positive for increased nuchal translucency or multiple marker screen positive for trisomy 18 or rubella screening - blood sent or rubella screening status. 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.

ICD-10:Z36.9
Short Description:Encounter for antenatal screening, unspecified
Long Description:Encounter for antenatal screening, unspecified

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 Z36.9 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:

  • Maternity diagnoses - Maternity. Age range is 12–55 years inclusive (e.g., diabetes in pregnancy, antepartum pulmonary complication).
  • Diagnoses for females only - Medicare Code Editor detects inconsistencies between a patient’s sex and any diagnosis on the patient’s record, this code applies to FEMALES only .

Synonyms

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

  • Multiple marker screen positive for increased nuchal translucency
  • Multiple marker screen positive for trisomy 18
  • Rubella screening - blood sent
  • Rubella screening status

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 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

Replacement Code

Z369 replaces the following previously assigned ICD-10 code(s):

  • Z36 - Encounter for antenatal screening of mother

Convert Z36.9 to ICD-9

  • V28.9 - Antenatal screening NOS

Code Classification

  • Factors influencing health status and contact with health services (Z00–Z99)
    • Persons encountering health services in circumstances related to reproduction (Z30-Z39)
      • Encounter for antenatal screening of mother (Z36)

Code History

  • FY 2018 - Code Added, 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


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]