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2025 ICD-10-CM code Z11.52

Encounter for screening for COVID-19.

Before October 1, 2023, Z11.52 was not to be used during the COVID-19 pandemic. After this date, following the end of the Public Health Emergency, the guidelines were updated to allow the use of Z11.52 for asymptomatic screening encounters.

Medical necessity for COVID-19 screening is determined by various factors such as public health recommendations, institutional policies, and specific requirements for travel, employment, or procedures. Documentation should support the reason for screening.

IMPORTANT:During the COVID-19 pandemic (before October 1, 2023), Z11.52 was not used for screening. Instead, codes like Z20.822 (Contact with and (suspected) exposure to COVID-19) or U07.1 (COVID-19) were used depending on the test result and symptoms.

In simple words: This code is used when a person without COVID-19 symptoms is tested for the virus, often as part of a routine check or requirement.

This code is used for encounters specifically for the purpose of screening for COVID-19 in asymptomatic individuals. This could occur in various settings such as clinics, hospitals, or testing centers. The screening process typically involves testing to identify potential COVID-19 cases early and prevent the spread of the virus.

Example 1: A hospital requires all pre-surgical patients to undergo a COVID-19 test. An asymptomatic patient presents for a scheduled surgery and is tested for COVID-19. The primary diagnosis code would be Z01.812 (Encounter for preprocedural laboratory examination) and Z11.52 would be a secondary diagnosis., A nursing home routinely tests its staff weekly for COVID-19 to ensure early detection and prevent outbreaks. An asymptomatic staff member is tested as part of this routine screening program. Z11.52 is used to document the reason for the encounter., An individual requires a negative COVID-19 test for travel. They are asymptomatic and present to a clinic specifically for this test. Z11.52 is the appropriate code for this encounter.

Documentation should clearly state that the patient is asymptomatic and the encounter is specifically for COVID-19 screening. The reason for the screening (e.g., travel, work, pre-operative requirement) should also be documented.

** Z codes represent reasons for encounters. A corresponding procedure code must accompany a Z code if a procedure is performed.

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