Is Z00.5 a billable ICD-10-CM code?

Yes. Z00.5 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does Z00.5 sit in the tabular list?

Factors influencing health status and contact with health services (Z00-Z99), in the block Persons encountering health services for examinations (Z00-Z13).

What cannot be coded together with Z00.5?

Z00.5 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above Z00.5 (Z00) and apply to it just the same.

Z00.5

Z00.5 — Encounter for examination of potential donor of organ and tissue

Billable / specific codeICD-10-CMPOA exempt

Z00.5 is a billable, specific ICD-10-CM code for encounter for examination of potential donor of organ and tissue. It is valid for submission on a claim.

Excludes1 inherited from the categories above Z00.5

These are not written on Z00.5, but they bind it: a note on a category applies to every code beneath it. Billing Z00.5 with anything listed here is a denial.

Written on Z00 — Encounter for general examination without complaint, suspected or reported diagnosis

encounter for examination for administrative purposes (Z02.-)

Excludes2 inherited from the categories above Z00.5

Also inherited, and the opposite of Excludes1: these conditions are not part of Z00.5, but a patient can have both, so you may code both.

Written on Z00 — Encounter for general examination without complaint, suspected or reported diagnosis

encounter for pre-procedural examinations (Z01.81-)
special screening examinations (Z11-Z13)

Other codes that can never be billed with Z00.5

These codes carry an Excludes1 note pointing at Z00.5. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading Z00.5 alone.

Z52Donors of organs and tissues

Risk adjustment

Z00.5 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.

Medicare coverage

Z00.5 is named in 2 Medicare coverage policies — 2 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

A56747Billing and Coding: Magnetic Resonance Angiography (MRA)
A56805Billing and Coding: Magnetic Resonance Angiography (MRA)

How Z00.5 is indexed

Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to Z00.5.

Donor›potential, examination of
Examination›donor(potential)
Admission›examination at health care facility›donor(potential)
Examination›medical›donor(potential)

Code history

Z00.5 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.

Related codes at this level

Codes that share Z00. If Z00.5 is not quite right, the correct code is usually one of these.

Questions about Z00.5

Is Z00.5 a billable ICD-10-CM code?: Yes. Z00.5 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does Z00.5 sit in the tabular list?: Factors influencing health status and contact with health services (Z00-Z99), in the block Persons encountering health services for examinations (Z00-Z13).
What cannot be coded together with Z00.5?: Z00.5 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above Z00.5 (Z00) and apply to it just the same.