DxCodebookFY2027 · Oct 1, 2026 – Sep 30, 2027

Category · FY2027

Z04 Encounter for examination and observation for other reasons

  • Header · not billable

Z04 is not billable. The category heads 12 billable codes in FY2027, grouped under 8 subdivisions.

Index → code

  • Investigation → Z04.9
  • Request for expert evidence → Z04.89
  • Observation (following) (for) (without need for further medical care) → Z04.9

Where it sits

  1. Chapter 21 Factors influencing health status and contact with health services (Z00-Z99)
  2. Z00-Z13 Persons encountering health services for examinations (Z00-Z13)
  3. Z04 Encounter for examination and observation for other reasons
Billable codes
12
Subdivisions
8
CC / MCC codes
0 / 0
HCC V28 codes
0
New FY2027
0
Index entries
43

Codes in Z04

  1. Z04.1
    Encounter for examination and observation following transport accident
    Billable
    Excludes1 1

    Excludes1

    • encounter for examination and observation following work accident (Z04.2) Z04.2
  2. Z04.2
    Encounter for examination and observation following work accident
    Billable
  3. Z04.3
    Encounter for examination and observation following other accident
    Billable
  4. Z04.4
    Encounter for examination and observation following alleged rape
    Header
    Inclusion terms 2

    Inclusion terms

    • Encounter for examination and observation of victim following alleged rape
    • Encounter for examination and observation of victim following alleged sexual abuse
  5. Z04.41
    Encounter for examination and observation following alleged adult rape
    Billable
    Inclusion terms 2

    Inclusion terms

    • Suspected adult rape, ruled out
    • Suspected adult sexual abuse, ruled out
  6. Z04.42
    Encounter for examination and observation following alleged child rape
    Billable
    Inclusion terms 2

    Inclusion terms

    • Suspected child rape, ruled out
    • Suspected child sexual abuse, ruled out
  7. Z04.6
    Encounter for general psychiatric examination, requested by authority
    Billable
  8. Z04.7
    Encounter for examination and observation following alleged physical abuse
    Header
  9. Z04.71
    Encounter for examination and observation following alleged adult physical abuse
    Billable
    Inclusion terms 1, Excludes1 3

    Inclusion terms

    • Suspected adult physical abuse, ruled out

    Excludes1

    • confirmed case of adult physical abuse (T74.-) T74
    • encounter for examination and observation following alleged adult sexual abuse (Z04.41) Z04.41
    • suspected case of adult physical abuse, not ruled out (T76.-) T76
  10. Z04.72
    Encounter for examination and observation following alleged child physical abuse
    Billable
    Inclusion terms 1, Excludes1 3

    Inclusion terms

    • Suspected child physical abuse, ruled out

    Excludes1

    • confirmed case of child physical abuse (T74.-) T74
    • encounter for examination and observation following alleged child sexual abuse (Z04.42) Z04.42
    • suspected case of child physical abuse, not ruled out (T76.-) T76
  11. Z04.8
    Encounter for examination and observation for other specified reasons
    Header
    Inclusion terms 1

    Inclusion terms

    • Encounter for examination and observation for request for expert evidence
  12. Z04.81
    Encounter for examination and observation of victim following forced sexual exploitation
    BillableExempt
  13. Z04.82
    Encounter for examination and observation of victim following forced labor exploitation
    BillableExempt
  14. Z04.89
    Encounter for examination and observation for other specified reasons
    BillableExempt
  15. Z04.9
    Encounter for examination and observation for unspecified reason
    Billable
    Inclusion terms 1

    Inclusion terms

    • Encounter for observation NOS

Sources of each column.

Instructions

At Z04

Includes

  • encounter for examination for medicolegal reasons
  • This category is to be used when a person without a diagnosis is suspected of having an abnormal condition, without signs or symptoms, which requires study, but after examination and observation, is ruled-out. This category is also for use for administrative and legal observation status.

Notes that also apply

Block Z00-Z13 instructions (Notes 1, Excludes2 1): printed on the block page.

Chapter 21 instructions (Notes 3): printed on the chapter 21 page.

Index entries

  • Request for expert evidence → Z04.89
  • Investigation → Z04.9
  • Observation (following) (for) (without need for further medical care) → Z04.9
  • Observation (following) (for) (without need for further medical care)following work accident → Z04.2
  • Observation (following) (for) (without need for further medical care)accident NEC → Z04.3
  • Examination (for) (following) (general) (of) (routine)forced sexual exploitation → Z04.81
  • Observation (following) (for) (without need for further medical care)forced sexual exploitation → Z04.81
  • Examination (for) (following) (general) (of) (routine)forced labor exploitation → Z04.82
  • Observation (following) (for) (without need for further medical care)forced labor exploitation → Z04.82
  • Examination (for) (following) (general) (of) (routine)medicolegal reason NEC → Z04.89
  • Examination (for) (following) (general) (of) (routine)specified type or reason NEC → Z04.89
  • Observation (following) (for) (without need for further medical care)criminal assault → Z04.89
  • Examination (for) (following) (general) (of) (routine)followingmotor vehicle accident → Z04.1
  • Observation (following) (for) (without need for further medical care)accident NECtransport → Z04.1
  • Observation (following) (for) (without need for further medical care)accident NECat work → Z04.2
  • Observation (following) (for) (without need for further medical care)suspected, ruled outaccident at work → Z04.2
  • Examination (for) (following) (general) (of) (routine)followingaccident NEC → Z04.3
  • Examination (for) (following) (general) (of) (routine)alleged rape or sexual assault (victim), ruled outadult → Z04.41
  • Observation (following) (for) (without need for further medical care)alleged rape or sexual assault (victim), ruled outadult → Z04.41
  • Rapealleged, observation or examination, ruled outadult → Z04.41
  • Examination (for) (following) (general) (of) (routine)alleged rape or sexual assault (victim), ruled outchild → Z04.42
  • Observation (following) (for) (without need for further medical care)alleged rape or sexual assault (victim), ruled outchild → Z04.42
  • Rapealleged, observation or examination, ruled outchild → Z04.42
  • Admission (for)mental health evaluationrequested by authority → Z04.6
  • Admission (for)psychiatric examination (general)requested by authority → Z04.6
  • Evaluation (for) (of)mental health (status)requested by authority → Z04.6
  • Examination (for) (following) (general) (of) (routine)psychiatric NECrequested by authority → Z04.6
  • Examination (for) (following) (general) (of) (routine)abuse, physical (alleged), ruled outadult → Z04.71
  • Observation (following) (for) (without need for further medical care)suspected, ruled outadult battering victim → Z04.71
  • Examination (for) (following) (general) (of) (routine)abuse, physical (alleged), ruled outchild → Z04.72
  • Observation (following) (for) (without need for further medical care)suspected, ruled outchild battering victim → Z04.72
  • Examination (for) (following) (general) (of) (routine)medical (adult) (for) (of)medicolegal reasons NEC → Z04.89
  • Observation (following) (for) (without need for further medical care)suspected, ruled outinflicted injury NEC → Z04.89
  • Test, tests, testing (for)laboratory (as part of a general medical examination)for medicolegal reason NEC → Z04.89
  • Examination (for) (following) (general) (of) (routine)followingaccident NECtransport → Z04.1
  • Examination (for) (following) (general) (of) (routine)followingaccident NECwork → Z04.2
  • Admission (for)examination at health care facility (adult)psychiatric (general)requested by authority → Z04.6
  • Examination (for) (following) (general) (of) (routine)followingassault, alleged, ruled outadult → Z04.71
  • Observation (following) (for) (without need for further medical care)suspected, ruled outabuse, physicaladult → Z04.71
  • Examination (for) (following) (general) (of) (routine)followingassault, alleged, ruled outchild → Z04.72

3 more, longer entries are not listed; the search box finds them by word.

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