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Z04.42

Z04.42Encounter for examination and observation following alleged child rape

Billable / specific codeICD-10-CM

Z04.42 is a billable, specific ICD-10-CM code for encounter for examination and observation following alleged child rape. It is valid for submission on a claim.

Inclusion terms

Alternative wordings a physician may use in the chart for this same code.

  • Suspected child rape, ruled out
  • Suspected child sexual abuse, ruled out

Other codes that can never be billed with Z04.42

These codes carry an Excludes1 note pointing at Z04.42. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading Z04.42 alone.

  • T76Adult and child abuse, neglect and other maltreatment, suspected
  • Z04.72Encounter for examination and observation following alleged child physical abuse

Risk adjustment

Z04.42 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.

How Z04.42 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 Z04.42.

  • Examinationalleged rape or sexual assault, ruled outchild
  • Observationalleged rape or sexual assault, ruled outchild
  • Rapealleged, observation or examination, ruled outchild

Related codes at this level

Codes that share Z04.4. If Z04.42 is not quite right, the correct code is usually one of these.

Questions about Z04.42

Is Z04.42 a billable ICD-10-CM code?
Yes. Z04.42 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does Z04.42 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).
ICD-10-CMFY2026-Apr· effective April 1, 2026

Loaded directly from the CMS/NCHS ICD-10-CM public-domain release — see data sources and our editorial policy. If this page disagrees with the CMS tabular list, this page is wrong. Reference information for professional coders; not medical or billing advice.