ICD-10-CM Use Additional Code Notes · Chapter 21 · FY 2027 Z00-Z99

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

A Use Additional Code note means a second code should be added, after this one, to fully describe the condition. In Chapter 21 (Z00-Z99), notes printed in the chapter name other codes 42 times, and Use Additional Code Notes anywhere in the Tabular List name the chapter’s codes 304 times, covering 70 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
42
References in Its Notes
304
References to Its Codes
70
Chapter Codes Named
Z00-Z99
Chapter 21
Chapter 21

Use Additional Code Notes by the code that carries the note

22 of 22 shown
  • Z01.41 Encounter for routine gynecological examination applies to 2 codes
    • for screening for human papillomavirus, if applicable, (Z11.51)
    • for screening vaginal pap smear, if applicable (Z12.72)
    • to identify acquired absence of uterus, if applicable (Z90.71-)
  • Z02.83 Encounter for blood-alcohol and blood-drug test
    • code for findings of alcohol or drugs in blood (R78.-)
  • Z08 Encounter for follow-up examination after completed treatment for malignant neoplasm
    • code to identify any acquired absence of organs (Z90.-)
    • code to identify the personal history of malignant neoplasm (Z85.-)
  • Z09 Encounter for follow-up examination after completed treatment for conditions other than malignant neoplasm
    • code to identify any applicable history of disease code (Z86.-, Z87.-)
  • Z12 Encounter for screening for malignant neoplasms applies to 20 codes
    • code to identify any family history of malignant neoplasm (Z80.-)
  • Z12.72 Encounter for screening for malignant neoplasm of vagina
    • code to identify acquired absence of uterus (Z90.71-)
  • Z15 Genetic susceptibility to disease applies to 14 codes
    • code, if applicable, for any associated family history of the disease (Z80-Z84)
  • Z15.0 Genetic susceptibility to malignant neoplasm applies to 9 codes
    • code, if applicable, for any personal history of malignant neoplasm (Z85.-)
  • Z15.2 Genetic susceptibility to obesity
    • code to identify body mass index (BMI), if known (Z68.-)
  • Z28.3 Underimmunization status applies to 3 codes
    • immunization not carried out because of contraindication (Z28.0-)
    • immunization not carried out because of patient decision for other and unspecified reason (Z28.2-)
    • immunization not carried out because of patient decision for reasons of belief or group pressure (Z28.1)
    • immunization not carried out for other reason (Z28.8-)
  • Z31.43 Encounter for genetic testing of female for procreative management applies to 2 codes
    • code for recurrent pregnancy loss, if applicable (N96, O26.2-)
  • Z40.0 Encounter for prophylactic surgery for risk factors related to malignant neoplasms applies to 5 codes
    • code to identify risk factor, such as genetic susceptibility to malignant neoplasm Z15.-
  • Z47.1 Aftercare following joint replacement surgery
    • code to identify the joint (Z96.6-)
  • Z47.81 Encounter for orthopedic aftercare following surgical amputation
    • code to identify the limb amputated (Z89.-)
  • Z71.3 Dietary counseling and surveillance
    • code to identify body mass index (BMI), if known (Z68.-)
  • Z71.4 Alcohol abuse counseling and surveillance applies to 2 codes
    • code for alcohol abuse or dependence (F10.-)
  • Z71.5 Drug abuse counseling and surveillance applies to 2 codes
  • Z71.6 Tobacco abuse counseling
    • code for nicotine dependence (F17.-)
  • Z79.81 Long term (current) use of agents affecting estrogen receptors and estrogen levels applies to 3 codes
    • estrogen receptor positive status (Z17.0)
    • family history of breast cancer (Z80.3)
    • genetic susceptibility to malignant neoplasm (cancer) (Z15.0-)
    • personal history of breast cancer (Z85.3)
    • personal history of prostate cancer (Z85.46)
    • postmenopausal status (Z78.0)
  • Z85 Personal history of malignant neoplasm applies to 60 codes
    • alcohol use and dependence (F10.-)
    • exposure to environmental tobacco smoke (Z77.22)
    • history of tobacco dependence (Z87.891)
    • occupational exposure to environmental tobacco smoke (Z57.31)
    • tobacco dependence (F17.-)
    • tobacco use (Z72.0)
  • Z90.41 Acquired absence of pancreas applies to 2 codes
    • diabetes mellitus, postpancreatectomy (E13.-)
    • insulin use (Z79.4)
  • Z98.4 Cataract extraction status applies to 3 codes
    • code to identify intraocular lens implant status (Z96.1)

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 Use Additional Code Notes anywhere in the Tabular List, including notes in other chapters.

Questions About Use Additional Code Notes

What does a Use Additional Code note mean?

A Use Additional Code note tells you to add a second code, reported after the code that carries the note, to describe the condition completely. In an etiology/manifestation pair it sits at the etiology code and points to the manifestation (Section I.A.13). The FY 2027 Tabular List has 1,491 of them; 1,174 name other codes, with 1,438 references to 389 distinct codes, categories and ranges.

Where does the additional code go?

After the code carrying the note. For etiology/manifestation pairs the Guidelines are explicit: the etiology is sequenced first, followed by the manifestation code.

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.