2025 ICD-10-CM code Z72.5
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Factors influencing health status and contact with health services - Problems related to lifestyle Factors influencing health status and contact with health services (Z00-Z99) Feed
High-risk sexual behavior, encompassing promiscuity.
No modifiers are applicable to ICD-10 codes.
Medical necessity is established when a patient presents for healthcare services related to risk assessment, counseling, or testing associated with their high-risk sexual behavior.The purpose is to mitigate potential health risks and prevent sexually transmitted infections or other adverse consequences.
The clinical responsibility involves assessing the patient's sexual health risks, providing counseling on safe sexual practices (including risk reduction strategies such as safer sex practices, STI testing, and PrEP/PEP), and potentially ordering diagnostic tests if indicated.Further management may depend on the findings.
- Factors influencing health status and contact with health services (Z00-Z99)
- Z72: Problems related to lifestyle
In simple words: This code is used when someone goes to the doctor because of concerns about their sexual activity, such as having many partners without protection.It's used even if they don't have any illness or injury at the time.
This ICD-10-CM code signifies high-risk sexual behavior, which includes but isn't limited to promiscuity.It's used when a patient presents for healthcare services due to concerns related to their sexual practices, regardless of the presence of a specific illness or injury at the time of the encounter. The code excludes paraphilias (F65), problems related to life-management difficulties (Z73.-), and problems related to socioeconomic and psychosocial circumstances (Z55-Z65).
Example 1: A 25-year-old male presents for a routine check-up, disclosing he has multiple sexual partners without consistent condom use.Z72.5 is coded to document the high-risk sexual behavior., A 30-year-old female seeks testing for sexually transmitted infections (STIs) after engaging in unprotected sex with a new partner.Z72.5 would be coded alongside the codes for specific STI tests, such as those for chlamydia or gonorrhea., A 40-year-old individual presents to the clinic expressing concerns about their high-risk sexual behavior and seeking information regarding PrEP (pre-exposure prophylaxis).Z72.5 is used to reflect this encounter.
Documentation should include a detailed history of sexual behaviors, number of partners, types of sexual activity, and condom use.If STI testing is performed, the results should be documented.Any counseling provided should also be noted in the medical record.
** This code is intended to capture high-risk sexual behaviors as a reason for the encounter.It is crucial to differentiate between high-risk sexual behavior (Z72.5) and specific diagnoses, such as STIs or HIV. When appropriate, additional codes should be added to capture these diagnoses or related conditions.
- Revenue Code: Revenue codes will vary depending on the services provided and the payer. Consult your specific payer guidelines.
- RVU: RVUs are not directly associated with ICD-10 codes. Reimbursement is determined by the procedures performed and the associated CPT codes, along with payer-specific factors.
- Global Days: Not applicable to ICD-10 codes.
- Payment Status: Active
- Modifier TC rule: Not applicable to ICD-10 codes.
- Fee Schedule: Not applicable to ICD-10 codes.
- Specialties:Infectious disease, family medicine, internal medicine, gynecology, urology
- Place of Service:Office, clinic, hospital outpatient department