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2025 ICD-10-CM code Z72.5

High-risk sexual behavior, encompassing promiscuity.

Follow official ICD-10-CM coding guidelines. Ensure that the code accurately reflects the reason for the encounter and that it is used appropriately in conjunction with other relevant codes (such as those for procedures performed or diagnoses made).Note that this is a reason for encounter code, not a diagnosis of a disease.

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.

IMPORTANT:This code may be used in conjunction with other codes, depending on the specific circumstances and the reason for the encounter.For example, codes related to sexually transmitted infections (STIs) or HIV might be used alongside Z72.5.More specific codes (e.g., Z72.51 High-risk homosexual behavior, Z72.52 High-risk bisexual behavior, Z72.53 High-risk heterosexual behavior) may be utilized if more detailed information is available.Consider also Z77.21 for contact with and (suspected) exposure to potentially hazardous body fluids.

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.

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