Z11.3

Z11.3: Encounter for screening for infections with a predominantly sexual mode of transmission

Billable / specific codeICD-10-CMPOA exempt

Z11.3 is a billable, specific ICD-10-CM code for encounter for screening for infections with a predominantly sexual mode of transmission. It is valid for submission on a claim.

Check Z11.3 with the rest of the claim: free scrubber

Excludes2: not included here, but may coexist

The excluded condition is not part of this code, but a patient can have both. You may code both.

encounter for screening for human immunodeficiency virus [HIV] (Z11.4)
encounter for screening for human papillomavirus (Z11.51)

Excludes1 inherited from the categories above Z11.3

A category’s note binds every code beneath it.

Written on Z11: Encounter for screening for infectious and parasitic diseases

encounter for diagnostic examination-code to sign or symptom

Risk adjustment

No CMS-HCC V28 category: this code does not change a RAF score.

Medicare coverage

Z11.3 is named in 4 Medicare coverage policies: 4 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.

A58710Billing and Coding: MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing
A58720Billing and Coding: MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing
A58747Billing and Coding: MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing
A58761Billing and Coding: MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing

Alphabetic index entries that lead here

Screening›gonorrhea
Screening›sexually-transmitted disease NEC
Screening›syphilis
Screening›venereal disease
Test, tests, testing›Wassermann
Screening›disease or disorder›sexually-transmitted NEC
Screening›disease or disorder›venereal

Code history

Unchanged in every release from FY2024 to FY2027.