Z11.4: Encounter for Screening for Human Immunodeficiency Virus [HIV]
Z11.4 is a billable/Specific ICD-10-CM code.
Purpose: Primarily used for preventive care visits where patients undergo HIV testing.
Relationship to Z11.3: While ICD Z11.3 is a broader code for general STI screening, Z11.4 specifically targets HIV.
Importance: Crucial for public health surveillance and early intervention in HIV prevention.
October 1, 2023: The Z11.4 became effective.
What is Diagnosis Code Z11.4
This is an ICD-10-CM code used to indicate a medical encounter where a patient undergoes screening for the Human Immunodeficiency Virus (HIV). It is specifically used when there is no prior diagnosis of HIV infection and the purpose of the visit is to determine the patient’s HIV status.
Approximate Synonyms
the most accurate and concise approximate synonyms for Z11.4 are:
- Screening for HIV
- Screening for human immunodeficiency virus
These terms directly and clearly reflect the purpose of the code.
Present on Admission (POA)
Generally, a condition coded as Z11.4 would not be considered “present on admission” (POA).
This is because a screening for HIV is typically performed as a preventative measure and is not a condition that a patient would have prior to admission to a hospital or other inpatient facility.
However, there are exceptions. If a patient is admitted to a hospital for complications related to HIV that was previously diagnosed, then the HIV condition might be considered POA. In this case, a different diagnosis code would be used to represent the underlying HIV condition, and Z11.4 might be used as a secondary diagnosis.
It’s essential to review the patient’s medical record carefully to determine the appropriate POA indicator for any given diagnosis.
Type 2 Excludes for Z11.4
Z11.3: Encounter for screening for infections with a predominantly sexual mode of transmission
This Type 2 Excludes means that while a patient might have both an HIV screening (Z11.4) and a general STI screening (Z11.3), these are considered separate encounters and can be coded together.
In essence, a patient can have both Z11.3 and Z11.4 codes on the same encounter form.
Reimbursement claims:
- ICD-10-CM codes are mandatory for all reimbursement claims with a date of service on or after October 1, 2015.
- ICD-9-CM codes are no longer accepted for claims with dates of service on or after October 1, 2015.
Conclusion
Our exploration of Z11.4, the ICD-10-CM code for an encounter for screening for human immunodeficiency virus (HIV), has covered essential aspects such as its definition, purpose, historical context, and usage. We have examined its relationship with other codes, like Z11.3, and clarified its role in public health surveillance and patient care.
