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v1.0.0
ICD-10 Guide
ICD-10 CodesZ11.7

Z11.7

Encounter for testing for latent tuberculosis infection

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/12/2025

Code Description

ICD-10 Z11.7 is a billable code used to indicate a diagnosis of encounter for testing for latent tuberculosis infection.

Key Diagnostic Point:

Z11.7 is used to indicate an encounter for testing for latent tuberculosis infection (LTBI). This code is crucial in preventive health care, particularly in populations at higher risk for tuberculosis (TB) exposure, such as healthcare workers, individuals with compromised immune systems, and those living in congregate settings. Testing for LTBI is a proactive measure to identify individuals who may not show active symptoms but are at risk of developing TB disease. Social determinants of health, such as socioeconomic status, access to healthcare, and living conditions, significantly influence the likelihood of TB exposure and the need for screening. Preventive care through LTBI testing is essential in controlling TB spread, especially in communities with high incidence rates. Proper documentation of risk factors, patient history, and the rationale for testing is vital for accurate coding and reimbursement.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Need for thorough patient history to determine risk factors.
  • Documentation of social determinants affecting health status.
  • Differentiation between latent and active TB requires clinical judgment.
  • Potential for co-morbid conditions that may complicate coding.

Audit Risk Factors

  • Inadequate documentation of risk factors for TB exposure.
  • Failure to document the rationale for testing.
  • Misclassification of LTBI as active TB.
  • Lack of follow-up documentation for positive LTBI tests.

Specialty Focus

Medical Specialties

Primary Care

Documentation Requirements

Document patient history, risk factors, and rationale for LTBI testing.

Common Clinical Scenarios

Routine checkups where TB risk is assessed, screenings for at-risk populations.

Billing Considerations

Consider social determinants such as housing stability and access to healthcare services.

Public Health

Documentation Requirements

Population-level data collection, surveillance of TB incidence, and reporting.

Common Clinical Scenarios

Community outreach programs targeting high-risk groups for TB screening.

Billing Considerations

Focus on epidemiological data and tracking health outcomes in vulnerable populations.

Coding Guidelines

Inclusion Criteria

Use Z11.7 When
  • Z codes are used to indicate encounters for circumstances other than disease or injury
  • 7 should be used when a patient is being tested for LTBI, and it is essential to document the reason for the test, including risk factors
  • This code should be sequenced appropriately, often as a secondary diagnosis when a related condition is present
  • Payer requirements may vary, so it is important to verify coverage for preventive services

Exclusion Criteria

Do NOT use Z11.7 When
No specific exclusions found.

Related CPT Codes

86580CPT Code

Tuberculin skin test (TST)

Clinical Scenario

Used during an encounter for LTBI testing.

Documentation Requirements

Document the administration of the test and the results.

Specialty Considerations

Primary care providers should ensure follow-up for test results.

86480CPT Code

Interferon-gamma release assay (IGRA)

Clinical Scenario

Used as an alternative to TST for LTBI testing.

Documentation Requirements

Document the test performed and the interpretation of results.

Specialty Considerations

Public health settings may use IGRA for more accurate screening in certain populations.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for greater specificity in coding LTBI encounters, improving data collection and public health tracking.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for greater specificity in coding LTBI encounters, improving data collection and public health tracking.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for greater specificity in coding LTBI encounters, improving data collection and public health tracking.

Resources

Clinical References

  • •
    CDC Guidelines for Latent Tuberculosis Infection

Coding & Billing References

  • •
    CDC Guidelines for Latent Tuberculosis Infection

Frequently Asked Questions

What documentation is required for Z11.7?

Documentation must include the patient's risk factors for TB exposure, the reason for testing, and any follow-up plans. It is essential to provide a clear clinical context to support the use of this Z code.