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v1.0.0
ICD-10 Guide
ICD-10 CodesZ22.35

Z22.35

Carrier of Enterobacterales

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

Code Description

ICD-10 Z22.35 is a billable code used to indicate a diagnosis of carrier of enterobacterales.

Key Diagnostic Point:

Z22.35 identifies individuals who are carriers of Enterobacterales, a family of bacteria that includes important pathogens such as Escherichia coli and Klebsiella pneumoniae. Carriers may not exhibit symptoms but can transmit these bacteria to others, posing a risk for infections, particularly in vulnerable populations. Understanding the social determinants of health, such as access to healthcare, socioeconomic status, and community health resources, is crucial in managing carriers. Preventive care strategies include education on hygiene practices and screening for at-risk populations, especially in healthcare settings. Regular monitoring and aftercare are essential to prevent outbreaks and manage potential complications. This code is vital for tracking epidemiological data and ensuring appropriate public health responses.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Need for thorough documentation of carrier status and potential transmission risks.
  • Understanding of social determinants affecting carrier prevalence.
  • Differentiation from symptomatic infections requiring different coding.
  • Potential for co-morbid conditions that may complicate coding.

Audit Risk Factors

  • Inadequate documentation of carrier status.
  • Failure to link Z code with appropriate preventive services.
  • Misclassification of carriers as symptomatic infections.
  • Lack of follow-up documentation for aftercare.

Specialty Focus

Medical Specialties

Primary Care

Documentation Requirements

Documentation should include patient history, risk factors for transmission, and preventive measures taken.

Common Clinical Scenarios

Routine checkups where carrier status is identified, screenings for at-risk populations, and aftercare follow-ups.

Billing Considerations

Consideration of social determinants such as living conditions, access to healthcare, and community health education.

Public Health

Documentation Requirements

Population-level data collection, surveillance reports, and documentation of interventions.

Common Clinical Scenarios

Epidemiological studies, outbreak investigations, and preventive health campaigns.

Billing Considerations

Focus on tracking health status and implementing community-wide preventive measures.

Coding Guidelines

Inclusion Criteria

Use Z22.35 When
  • Z codes are used to indicate factors influencing health status and should be sequenced appropriately
  • 35 should be used when the carrier status is relevant to the patient's care
  • Payer requirements may vary, so it is essential to check specific guidelines for coverage of preventive services

Exclusion Criteria

Do NOT use Z22.35 When
No specific exclusions found.

Related CPT Codes

99385CPT Code

Initial preventive medicine evaluation and management, new patient

Clinical Scenario

Used during a preventive visit where carrier status is assessed.

Documentation Requirements

Complete history and physical examination, risk assessment, and preventive counseling.

Specialty Considerations

Primary care providers should document social determinants impacting health.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for greater specificity in coding carrier status, improving data collection and public health responses.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for greater specificity in coding carrier status, improving data collection and public health responses.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for greater specificity in coding carrier status, improving data collection and public health responses.

Resources

Clinical References

  • •
    CDC Guidelines on Enterobacterales

Coding & Billing References

  • •
    CDC Guidelines on Enterobacterales

Frequently Asked Questions

What should be documented to support the use of Z22.35?

Documentation should include the patient's carrier status, any risk factors for transmission, preventive measures discussed, and follow-up plans. Consideration of social determinants of health is also important.