2025 ICD-10-CM code Z20
Contact with and (suspected) exposure to communicable diseases.
No specific modifiers are typically applied to Z20, but general modifiers (e.g., for place of service) may be used as appropriate.
Medical necessity is established when a patient presents for evaluation due to potential exposure to a communicable disease, especially in situations involving high-risk exposures or outbreaks.The evaluation aims to detect early signs of infection, implement preventative measures, and control the spread of the disease.
The physician's responsibility involves evaluating the patient for signs and symptoms of a communicable disease after suspected exposure. This may include a physical exam, symptom review, and risk assessment.Further testing or preventative measures may be recommended based on the evaluation.
In simple words: This code is used when someone has been near someone with a contagious illness but hasn't gotten sick themselves.The doctor sees them to check for any signs of illness.
This ICD-10-CM code signifies an encounter for contact with or suspected exposure to communicable diseases.It's used when a patient presents for evaluation due to potential exposure, even without a confirmed diagnosis of a communicable disease.This code should not be used if the patient has a diagnosed infectious or parasitic disease; instead, the appropriate code for that specific disease should be used.Excludes notes clarify further distinctions.
Example 1: A patient presents to a clinic after being in close contact with someone diagnosed with influenza. The patient is asymptomatic but wants to be checked for influenza infection., A healthcare worker reports potential exposure to tuberculosis in the workplace. The physician conducts a risk assessment and orders a tuberculin skin test., A traveler returns from a region with an outbreak of measles. Although asymptomatic, they seek evaluation for potential measles exposure.
Documentation should include details of the patient's exposure (e.g., date, duration, nature of contact with the infected individual), any symptoms experienced, and the results of any diagnostic tests performed (e.g., serology, PCR).The physician's assessment of the risk of infection and any preventative measures recommended should also be documented.
** Z codes are used to report reasons for encounters.A Z code alone is not sufficient for billing; a procedural code must accompany it if a procedure is performed during the encounter.Always consult the latest ICD-10-CM coding guidelines for the most current information and clarifications.
- Payment Status: Active
- Modifier TC rule: Not applicable. Z20 is a diagnosis code, not a procedural code.
- Specialties:Infectious disease, Public health, Family medicine, Occupational medicine
- Place of Service:Office, Urgent Care Facility, Emergency Room - Hospital,Outpatient Hospital, Telehealth Provided in Patient’s Home, Telehealth Provided Other than in Patient’s Home