Is Z13.5 a billable ICD-10-CM code?

Yes. Z13.5 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does Z13.5 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 Z13.5?

Z13.5 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 Z13.5 (Z13) and apply to it just the same.

Z13.5

Z13.5 — Encounter for screening for eye and ear disorders

Billable / specific codeICD-10-CMPOA exempt

Z13.5 is a billable, specific ICD-10-CM code for encounter for screening for eye and ear disorders. It is valid for submission on a claim.

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 general hearing examination (Z01.1-)
encounter for general vision examination (Z01.0-)

Excludes1 inherited from the categories above Z13.5

These are not written on Z13.5, but they bind it: a note on a category applies to every code beneath it. Billing Z13.5 with anything listed here is a denial.

Written on Z13 — Encounter for screening for other diseases and disorders

encounter for diagnostic examination-code to sign or symptom

Risk adjustment

Z13.5 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

Z13.5 is named in 1 Medicare coverage policy — 1 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

A53495Glaucoma Screening

How Z13.5 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 Z13.5.

Screening›cataract
Screening›glaucoma
Screening›congenital›eye disorder
Screening›disease or disorder›ear
Screening›disease or disorder›eye

Code history

Z13.5 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 Z13. If Z13.5 is not quite right, the correct code is usually one of these.

Questions about Z13.5

Is Z13.5 a billable ICD-10-CM code?: Yes. Z13.5 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does Z13.5 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 Z13.5?: Z13.5 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 Z13.5 (Z13) and apply to it just the same.