2027 ICD-10-CM Diagnosis Code Z55.2Failed school examinations
Z55.2 is a billable ICD-10-CM diagnosis code for failed school examinations. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 951. 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 academic problem. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Socioeconomic/psychosocial factors.
Code Identity
Code Classification
Code EditsBilling
Medicare Code Editor checks that affect claim validity for Z55.2.
Present on Admission (POA)Billing
Z55.2 is exempt from POA reporting on inpatient claims to general acute care hospitals. Review the other POA exempt codes in Persons with potential health hazards related to socioeconomic and psychosocial circumstances (Z55-Z65).
Approximate SynonymsGuidance
Alternate terms and clinical phrases that map to this code.
- Academic problem
- Failed exams
- Qualifications failed
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to Z55.2: its own notes plus those printed at Z55 and Chapter 21. A note printed at a category, block or chapter applies to every code under it.
Excludes1
Not coded here: the excluded code is never reported together with this one, unless the two conditions are unrelated.
Notes
General instructions on how these codes are used.
- Z codes represent reasons for encounters. A corresponding procedure code must accompany a Z code if a procedure is performed. Categories Z00-Z99 are provided for occasions when circumstances other than a disease, injury or external cause classifiable to categories A00-Y89 are recorded as 'diagnoses' or 'problems'. This can arise in two main ways:
- (a) When a person who may or may not be sick encounters the health services for some specific purpose, such as to receive limited care or service for a current condition, to donate an organ or tissue, to receive prophylactic vaccination (immunization), or to discuss a problem which is in itself not a disease or injury.
- (b) When some circumstance or problem is present which influences the person's health status but is not in itself a current illness or injury.
Source: CMS ICD-10-CM Tabular List. How to read instructional notes.
Index to Diseases and InjuriesGuidance
Alphabetical index entries that point to this code.
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Convert Z55.2 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About Z55.2Overview
What is the ICD-10 code for failed school examinations?
The ICD-10-CM code for failed school examinations is Z55.2 (sometimes written as Z552). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
Is Z55.2 (Problems related to education and literacy) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report failed school examinations on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What MS-DRG does Z55.2 group to?
On inpatient claims, failed school examinations maps to MS-DRG 951 (other Factors Influencing Health Status), which carries a relative weight of 0.5574. Higher weights mean higher Medicare reimbursement.
Can Z55.2 be a principal diagnosis?
No. The Medicare Code Editor rejects this code as a principal diagnosis because failed school examinations describes a circumstance that influences health status rather than a current illness. Report it as a secondary diagnosis.
Is Z55.2 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 failed school examinations on inpatient claims. The code appears in the Persons with potential health hazards related to socioeconomic and psychosocial circumstances (Z55-Z65) range of the CMS exempt list.
