2025 ICD-10-CM code Z72.53
High risk bisexual behavior.
Medical necessity relates to the justification for services provided. For Z72.53, services like STI screenings, PrEP consultations, or risk-reduction counseling become medically necessary due to the elevated risk associated with the documented behavior. The specific requirements for medical necessity are generally defined by payers and may vary.
Clinicians use this code to indicate behaviors that may necessitate preventative measures, screenings, or further education regarding safe sexual practices. The code itself does not imply a diagnosis of an STI, but is a risk factor.
- 21. Factors influencing health status and contact with health services (Z00-Z99)
- Persons encountering health services in other circumstances (Z69-Z76)
In simple words: This code indicates that the patient engages in bisexual activity that carries a higher risk of sexually transmitted diseases.
High risk bisexual behavior.This code is used to document a patient's bisexual behavior that is considered high risk, often due to practices that increase the chance of contracting sexually transmitted infections (STIs).It is important to note that this code should not be used to judge a patient's lifestyle but rather to accurately reflect risk factors for appropriate medical care.
Example 1: A patient identifies as bisexual and reports inconsistent condom use with multiple partners.This scenario warrants the use of Z72.53 due to the increased risk of STIs., A bisexual patient seeks PrEP (pre-exposure prophylaxis) for HIV prevention, indicating awareness of potential exposure risks.Z72.53 would be an appropriate code to use in this context., A patient presents for STI testing following a potential exposure and discloses bisexual activity. The code Z72.53 is applicable, particularly if the activity includes factors associated with higher transmission rates.
Documentation should include the patient's self-reported sexual orientation and detailed information about their sexual practices, including frequency of sexual activity, number of partners, and consistency of condom use.
** The use of Z72.53 can be sensitive and should be done respectfully, ensuring the patient understands the reason for the code.It is also important for healthcare professionals to be aware of the potential for bias related to sexual orientation and to avoid making judgments or stigmatizing patients.Instead, Z72.53 should be used as a tool to facilitate appropriate healthcare and risk reduction strategies.
- Specialties:Family Medicine, Infectious Disease, Urology, Internal Medicine, Public Health
- Place of Service:Office, Outpatient Hospital, Public Health Clinic, Federally Qualified Health Center, Telehealth Provided in Patient’s Home, Telehealth Provided Other than in Patient’s Home