ICD-10-CM Excludes2 Notes · Chapter 21 · FY 2027 Z00-Z99

Excludes2 Notes in Chapter 21: Factors influencing health status and contact with health services ICD-10-CM

An Excludes2 note means "NOT INCLUDED HERE": the excluded condition is not part of this code, but a patient may have both, so both codes may be reported. In Chapter 21 (Z00-Z99), notes printed in the chapter name other codes 204 times, and Excludes2 Notes anywhere in the Tabular List name the chapter’s codes 191 times, covering 134 distinct codes, categories and ranges. Switch views to read the list either way.

✓ From the official FY 2027 ICD-10-CM Tabular ListDefinitions follow the Official Guidelines, Section I.A
204
References in Its Notes
191
References to Its Codes
134
Chapter Codes Named
Z00-Z99
Chapter 21
Chapter 21

Excludes2 Notes by the code that carries the note

116 of 116 shown
  • Block note Block Z00-Z13 Persons encountering health services for examinations applies to 156 codes
    • examinations related to pregnancy and reproduction (Z30-Z36, Z39.-)
  • Z00 Encounter for general examination without complaint, suspected or reported diagnosis applies to 13 codes
    • encounter for pre-procedural examinations (Z01.81-)
    • special screening examinations (Z11-Z13)
  • Z01 Encounter for other special examination without complaint, suspected or reported diagnosis applies to 23 codes
    • encounter for laboratory and radiologic examinations as a component of general medical examinations (Z00.0-)
    • screening examinations (Z11-Z13)
  • Z01.4 Encounter for gynecological examination applies to 3 codes
    • pregnancy examination or test (Z32.0-)
    • routine examination for contraceptive maintenance (Z30.4-)
  • Z02.84 Encounter for child welfare exam
    • encounter for examination and observation for alleged child physical abuse (Z04.72)
    • encounter for examination and observation for alleged child rape (Z04.42)
  • Z03.82 Encounter for observation for suspected foreign body ruled out applies to 3 codes
    • foreign body in alimentary tract (T18)
    • foreign body in ear (T16)
    • foreign body on external eye (T15)
    • foreign body in respiratory tract (T17)
  • Z11.3 Encounter for screening for infections with a predominantly sexual mode of transmission
    • encounter for screening for human immunodeficiency virus [HIV] (Z11.4)
    • encounter for screening for human papillomavirus (Z11.51)
  • Z11.5 Encounter for screening for other viral diseases applies to 3 codes
    • encounter for screening for viral intestinal disease (Z11.0)
  • Z11.6 Encounter for screening for other protozoal diseases and helminthiases
    • encounter for screening for protozoal intestinal disease (Z11.0)
  • Z12.4 Encounter for screening for malignant neoplasm of cervix
    • encounter for screening for human papillomavirus (Z11.51)
  • Z13.29 Encounter for screening for other suspected endocrine disorder
    • encounter for screening for diabetes mellitus (Z13.1)
  • Z13.4 Encounter for screening for certain developmental disorders in childhood applies to 4 codes
    • encounter for routine child health examination (Z00.12-)
  • Z13.5 Encounter for screening for eye and ear disorders
    • encounter for general hearing examination (Z01.1-)
    • encounter for general vision examination (Z01.0-)
  • Z13.8 Encounter for screening for other specified diseases and disorders applies to 11 codes
    • screening for malignant neoplasms (Z12.-)
  • Z16.12 Extended spectrum beta lactamase (ESBL) resistance
    • Methicillin resistant Staphylococcus aureus infection in diseases classified elsewhere (B95.62)
  • Z20 Contact with and (suspected) exposure to communicable diseases applies to 18 codes
    • personal history of infectious and parasitic diseases (Z86.1-)
  • Z22 Carrier of infectious disease applies to 20 codes
    • carrier of viral hepatitis (B18.-)
  • Z31 Encounter for procreative management applies to 20 codes
    • complications associated with artificial fertilization (N98.-)
    • female infertility (N97.-)
    • male infertility (N46.-)
  • Z36 Encounter for antenatal screening of mother applies to 17 codes
    • abnormal findings on antenatal screening of mother (O28.-)
    • genetic counseling and testing (Z31.43-, Z31.5)
    • routine prenatal care (Z34)
  • Block note Block Z40-Z53 Encounters for other specific health care applies to 164 codes
    • follow-up examination for medical surveillance after treatment (Z08-Z09)
  • Z43 Encounter for attention to artificial openings applies to 10 codes
    • fitting and adjustment of prosthetic and other devices (Z44-Z46)
  • Z43.1 Encounter for attention to gastrostomy
    • artificial opening status only, without need for care (Z93.-)
  • Z45 Encounter for adjustment and management of implanted device applies to 19 codes
    • encounter for fitting and adjustment of non-implanted device (Z46.-)
  • Z45.018 Encounter for adjustment and management of other part of cardiac pacemaker
  • Z46 Encounter for fitting and adjustment of other devices applies to 12 codes
    • encounter for fitting and management of implanted devices (Z45.-)
    • issue of repeat prescription only (Z76.0)
    • presence of prosthetic and other devices (Z95-Z97)
  • Z46.2 Encounter for fitting and adjustment of other devices related to nervous system and special senses
    • encounter for adjustment and management of implanted nervous system device (Z45.4-)
    • encounter for adjustment and management of implanted visual substitution device (Z45.31)
  • Z46.6 Encounter for fitting and adjustment of urinary device
    • attention to artificial openings of urinary tract (Z43.5, Z43.6)
  • Z48 Encounter for other postprocedural aftercare applies to 23 codes
    • encounter for attention to artificial openings (Z43.-)
    • encounter for fitting and adjustment of prosthetic and other devices (Z44-Z46)
  • Z48.81 Encounter for surgical aftercare following surgery on specified body systems applies to 8 codes
    • aftercare following organ transplant (Z48.2-)
    • orthopedic aftercare (Z47.-)
  • Z48.811 Encounter for surgical aftercare following surgery on the nervous system
    • encounter for surgical aftercare following surgery on the sense organs (Z48.810)
  • Z56 Problems related to employment and unemployment applies to 11 codes
    • occupational exposure to risk factors (Z57.-)
    • problems related to housing and economic circumstances (Z59.-)
  • Z57.31 Occupational exposure to environmental tobacco smoke
    • exposure to environmental tobacco smoke (Z77.22)
  • Z58 Problems related to physical environment applies to 3 codes
    • occupational exposure (Z57.-)
  • Z58.6 Inadequate drinking-water supply
    • deprivation of water (T73.1)
  • Z59 Problems related to housing and economic circumstances applies to 25 codes
    • problems related to upbringing (Z62.-)
  • Z59.1 Inadequate housing applies to 4 codes
    • problems related to the natural and physical environment (Z77.1-)
  • Z59.12 Inadequate housing utilities
    • basic services unavailable in physical environment (Z58.81)
    • financial insecurity, difficulty paying for utilities (Z59.861)
    • lack of adequate food (Z59.4-)
    • other problems related to housing and economic circumstances (Z59.8-)
  • Z59.4 Lack of adequate food applies to 2 codes
    • deprivation of food (T73.0)
    • effects of hunger (T73.0)
    • inappropriate diet or eating habits (Z72.4)
    • malnutrition (E40-E46)
  • Z59.819 Housing instability, housed unspecified
    • extreme poverty (Z59.5)
    • financial insecurity (Z59.86-)
    • low income (Z59.6)
    • material hardship due to limited financial resources, not elsewhere classified (Z59.87)
  • Z59.82 Transportation insecurity
    • unavailability and inaccessibility of healthcare facilities (Z75.3)
  • Z59.86 Financial insecurity applies to 3 codes
    • extreme poverty (Z59.5)
    • low income (Z59.6)
    • material hardship, not elsewhere classified (Z59.87)
  • Z59.861 Financial insecurity, difficulty paying for utilities
    • inadequate housing utilities (Z59.12)
  • Z59.87 Material hardship due to limited financial resources, not elsewhere classified
    • extreme poverty (Z59.5)
    • financial insecurity, not elsewhere classified (Z59.86-)
    • low income (Z59.6)
  • Z62 Problems related to upbringing applies to 28 codes
    • maltreatment syndrome (T74.-)
    • problems related to housing and economic circumstances (Z59.-)
  • Z62.815 Personal history of intimate partner abuse in childhood
    • adult and child abuse, neglect and other maltreatment, confirmed (T74.-)
  • Z63 Other problems related to primary support group, including family circumstances applies to 12 codes
    • maltreatment syndrome (T74.-, T76)
    • parent-child problems (Z62.-)
    • problems related to negative life events in childhood (Z62.-)
    • problems related to upbringing (Z62.-)
  • Z70 Counseling related to sexual attitude, behavior and orientation applies to 6 codes
    • contraceptive or procreative counseling (Z30-Z31)
  • Z71 Persons encountering health services for other counseling and medical advice, not elsewhere classified applies to 19 codes
    • contraceptive or procreation counseling (Z30-Z31)
    • sex counseling (Z70.-)
  • Z71.0 Person encountering health services to consult on behalf of another person
    • anxiety (normal) about sick person in family (Z63.7)
    • expectant (adoptive) parent(s) pre-birth pediatrician visit (Z76.81)
  • Z71.8 Other specified counseling applies to 8 codes
    • counseling for contraception (Z30.0-)
  • Z71.84 Encounter for health counseling related to travel
    • encounter for administrative examination (Z02.-)
    • encounter for other special examination without complaint, suspected or reported diagnosis (Z01.-)
  • Z72 Problems related to lifestyle applies to 14 codes
    • problems related to life-management difficulty (Z73.-)
    • problems related to socioeconomic and psychosocial circumstances (Z55-Z65)
  • Z73 Problems related to life management difficulty applies to 14 codes
    • problems related to socioeconomic and psychosocial circumstances (Z55-Z65)
  • Z74 Problems related to care provider dependency applies to 7 codes
    • dependence on enabling machines or devices NEC (Z99.-)
  • Z74.09 Other reduced mobility
    • wheelchair dependence (Z99.3)
  • Z76.0 Encounter for issue of repeat prescription
    • issue of medical certificate (Z02.7)
    • repeat prescription for contraceptive (Z30.4-)
  • Z77 Other contact with and (suspected) exposures hazardous to health applies to 31 codes
    • contact with and (suspected) exposure to communicable diseases (Z20.-)
    • exposure to (parental) (environmental) tobacco smoke in the perinatal period (P96.81)
    • newborn affected by noxious substances transmitted via placenta or breast milk (P04.-)
    • occupational exposure to risk factors (Z57.-)
    • retained foreign body (Z18.-)
    • retained foreign body fully removed (Z87.821)
    • toxic effects of substances chiefly nonmedicinal as to source (T51-T65)
  • Z77.123 Contact with and (suspected) exposure to radon and other naturally occurring radiation
    • radiation exposure as the cause of a confirmed condition (W88-W90, X39.0-)
    • radiation sickness NOS (T66)
  • Z77.22 Contact with and (suspected) exposure to environmental tobacco smoke (acute) (chronic)
    • occupational exposure to environmental tobacco smoke (Z57.31)
  • Z78 Other specified health status applies to 3 codes
    • asymptomatic human immunodeficiency virus [HIV] infection status (Z21)
    • postprocedural status (Z93-Z99)
    • sex reassignment status (Z87.890-)
  • Z78.0 Asymptomatic menopausal state
    • symptomatic menopausal state (N95.1)
  • Z79 Long term (current) drug therapy applies to 32 codes
    • drug abuse and dependence (F11-F19)
    • drug use complicating pregnancy, childbirth, and the puerperium (O99.32-)
  • Z79.0 Long term (current) use of anticoagulants and antithrombotics/antiplatelets applies to 2 codes
    • long term (current) use of aspirin (Z79.82)
  • Z79.1 Long term (current) use of non-steroidal anti-inflammatories (NSAID)
    • long term (current) use of aspirin (Z79.82)
  • Z79.4 Long term (current) use of insulin
    • long-term (current) use of injectable non-insulin antidiabetic drugs (Z79.85)
    • long term (current) use of oral antidiabetic drugs (Z79.84)
    • long term (current) use of oral hypoglycemic drugs (Z79.84)
  • Z79.6 Long term (current) use of immunomodulators and immunosuppressants applies to 14 codes
    • long term (current) use of steroids (Z79.5-)
    • long term (current) use of agents affecting estrogen receptors and estrogen levels (Z79.81-)
  • Z79.84 Long term (current) use of oral hypoglycemic drugs
    • long-term (current) use of injectable non-insulin antidiabetic drugs (Z79.85)
    • long term (current) use of insulin (Z79.4)
  • Z79.85 Long-term (current) use of injectable non-insulin antidiabetic drugs
    • long term (current) use of insulin (Z79.4)
    • long term (current) use of oral hypoglycemic drugs (Z79.84)
  • Z79.891 Long term (current) use of opiate analgesic
    • methadone use NOS (F11.9-)
    • use of methadone for treatment of heroin addiction (F11.2-)
  • Z82.5 Family history of asthma and other chronic lower respiratory diseases
    • family history of other diseases of the respiratory system (Z83.6)
  • Z83 Family history of other specific disorders applies to 19 codes
    • contact with and (suspected) exposure to communicable disease in the family (Z20.-)
  • Z83.51 Family history of eye disorders applies to 2 codes
    • family history of blindness and visual loss (Z82.1)
  • Z83.52 Family history of ear disorders
    • family history of deafness and hearing loss (Z82.2)
  • Z83.6 Family history of other diseases of the respiratory system
    • family history of asthma and other chronic lower respiratory diseases (Z82.5)
  • Z83.71 Family history of colonic polyps applies to 4 codes
    • family history of malignant neoplasm of digestive organs (Z80.0)
  • Z85 Personal history of malignant neoplasm applies to 60 codes
    • personal history of benign neoplasm (Z86.01-)
    • personal history of carcinoma-in-situ (Z86.00-)
  • Z85.831 Personal history of malignant neoplasm of soft tissue
    • personal history of malignant neoplasm of skin (Z85.82-)
  • Z86.0 Personal history of in-situ and benign neoplasms and neoplasms of uncertain behavior applies to 18 codes
    • personal history of malignant neoplasms (Z85.-)
  • Z86.31 Personal history of diabetic foot ulcer
  • Z86.7 Personal history of diseases of the circulatory system applies to 6 codes
    • old myocardial infarction (I25.2)
    • personal history of anaphylactic shock (Z87.892)
    • postmyocardial infarction syndrome (I24.1)
  • Z87.2 Personal history of diseases of the skin and subcutaneous tissue
    • personal history of diabetic foot ulcer (Z86.31)
  • Z87.3 Personal history of diseases of the musculoskeletal system and connective tissue applies to 4 codes
    • personal history of (healed) traumatic fracture (Z87.81)
  • Z87.311 Personal history of (healed) other pathological fracture
    • personal history of osteoporosis fracture (Z87.310)
  • Z87.5 Personal history of complications of pregnancy, childbirth and the puerperium applies to 2 codes
    • recurrent pregnancy loss (N96)
  • Z87.7 Personal history of (corrected) congenital malformations applies to 18 codes
    • other postprocedural states (Z98.-)
    • personal history of medical treatment (Z92.-)
    • presence of cardiac and vascular implants and grafts (Z95.-)
    • presence of other devices (Z97.-)
    • presence of other functional implants (Z96.-)
    • transplanted organ and tissue status (Z94.-)
  • Z87.8 Personal history of other specified conditions applies to 13 codes
    • personal history of self harm (Z91.5-)
  • Z87.81 Personal history of (healed) traumatic fracture
    • personal history of (healed) nontraumatic fracture (Z87.31-)
  • Z88 Allergy status to drugs, medicaments and biological substances applies to 10 codes
    • Allergy status, other than to drugs and biological substances (Z91.0-)
  • Z89.02 Acquired absence of other finger(s) applies to 3 codes
    • acquired absence of thumb (Z89.01-)
  • Z89.42 Acquired absence of other toe(s) applies to 3 codes
    • acquired absence of great toe (Z89.41-)
  • Z90 Acquired absence of organs, not elsewhere classified applies to 22 codes
    • postprocedural absence of endocrine glands (E89.-)
  • Z90.09 Acquired absence of other part of head and neck
  • Z90.7 Acquired absence of genital organ(s) applies to 6 codes
    • female genital mutilation status (N90.81-)
  • Z91 Personal risk factors, not elsewhere classified applies to 62 codes
    • contact with and (suspected) exposures hazardous to health (Z77.-)
    • exposure to pollution and other problems related to physical environment (Z77.1-)
    • female genital mutilation status (N90.81-)
    • occupational exposure to risk factors (Z57.-)
    • personal history of physical injury and trauma (Z87.81, Z87.82-)
  • Z91.0 Allergy status, other than to drugs and biological substances applies to 17 codes
    • Allergy status to drugs, medicaments, and biological substances (Z88.-)
  • Z91.01 Food allergy status applies to 10 codes
    • food additives allergy status (Z91.02)
  • Z91.1 Patient's noncompliance with medical treatment and regimen applies to 14 codes
    • caregiver noncompliance with patient's medical treatment and regimen (Z91.A-)
  • Z91.41 Personal history of adult abuse applies to 6 codes
    • personal history of abuse in childhood (Z62.81-)
  • Z91.82 Personal history of military deployment
    • personal history of military service (Z91.85)
  • Z91.85 Personal history of military service
    • personal history of military deployment (Z91.82)
  • Z92 Personal history of medical treatment applies to 19 codes
    • postprocedural states (Z98.-)
  • Z92.2 Personal history of drug therapy applies to 8 codes
    • long term (current) drug therapy (Z79.-)
  • Z92.22 Personal history of monoclonal drug therapy
    • personal history of immune checkpoint inhibitor therapy (Z92.26)
  • Z92.25 Personal history of immunosuppression therapy
    • personal history of steroid therapy (Z92.24)
  • Z92.83 Personal history of failed moderate sedation
    • failed moderate sedation during procedure (T88.52)
  • Z92.84 Personal history of unintended awareness under general anesthesia
    • unintended awareness under general anesthesia during procedure (T88.53)
  • Z92.85 Personal history of cellular therapy applies to 3 codes
    • personal history of immune checkpoint inhibitor therapy (Z92.26)
  • Z94 Transplanted organ and tissue status applies to 14 codes
    • presence of vascular grafts (Z95.-)
  • Z95 Presence of cardiac and vascular implants and grafts applies to 13 codes
    • complications of cardiac and vascular devices, implants and grafts (T82.-)
  • Z96 Presence of other functional implants applies to 40 codes
    • complications of internal prosthetic devices, implants and grafts (T82-T85)
    • fitting and adjustment of prosthetic and other devices (Z44-Z46)
  • Z97 Presence of other devices applies to 13 codes
    • fitting and adjustment of prosthetic and other devices (Z44-Z46)
    • presence of cerebrospinal fluid drainage device (Z98.2)
  • Z98 Other postprocedural states applies to 23 codes
  • Z98.0 Intestinal bypass and anastomosis status
    • bariatric surgery status (Z98.84)
    • gastric bypass status (Z98.84)
    • obesity surgery status (Z98.84)
  • Z98.84 Bariatric surgery status
    • intestinal bypass and anastomosis status (Z98.0)
  • Z98.870 Personal history of in utero procedure during pregnancy
    • complications from in utero procedure for current pregnancy (O35.7)
    • supervision of current pregnancy with history of in utero procedure during previous pregnancy (O09.82-)
  • Z99.2 Dependence on renal dialysis
    • noncompliance with renal dialysis (Z91.15-)

The first view lists notes printed in this chapter (a note on a category or block applies to every code beneath it). The second lists codes of this chapter named by Excludes2 Notes anywhere in the Tabular List, including notes in other chapters.

Questions About Excludes2 Notes

What does an Excludes2 note mean?

An Excludes2 note means “Not included here”: the excluded condition is not part of the condition represented by the code, but a patient may have both conditions at the same time (Section I.A.12.b). The FY 2027 Tabular List has 2,529 of them; 2,493 name other codes, with 2,799 references to 1,779 distinct codes, categories and ranges.

Can both codes be reported when there is an Excludes2 note?

Yes. When an Excludes2 note appears under a code, it is acceptable to use both the code and the excluded code together, when appropriate: that is, when the patient has both conditions and both are documented.

Related References

ICD-10-CM Official GuidelinesICD-10-CM Code LookupICD-10-CM Codes ListCode Lists by Tag

Source: FY 2027 ICD-10-CM Tabular List (CMS and NCHS) and the ICD-10-CM Official Guidelines for Coding and Reporting FY 2027, Section I.A. ICD List is not affiliated with CMS or NCHS.