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v1.0.0
ICD-10 Guide
DiagnosesScreening Hepatitis C

Screening Hepatitis C

ICD-10 Coding for Hepatitis C Screening(Z11.59, G0472)

PRIMARY SPECIALTYPrimary Care
COMPLEXITYHigh
LAST UPDATED09/15/2025
Sam Tuffun, PT, DPT
Physical Therapist | Medical Coding & Billing Contributor

Diagnosis Overview

What is Screening Hepatitis C?
Essential facts and insights about Hepatitis C Screening

Key Clinical Considerations:

  • Asymptomatic individuals at high risk for Hepatitis C
  • Positive Hepatitis C antibody test (anti-HCV)
  • Elevated liver enzymes (ALT/AST) in blood tests

Clinical Information

Clinical Criteria & Documentation Requirements

  • Patient's risk factors for Hepatitis C
  • Results of Hepatitis C antibody and confirmatory tests
  • Follow-up plan and patient education provided

Coding Guidelines

Usage Guidelines & Examples

  • Use Z11.59 for screening; B17.1 for diagnosed cases.
  • Common errors include using incorrect codes for screening vs. diagnosis.

Code Exclusions

Important Exclusions

  • Patients with known Hepatitis C infection
  • Codes for other liver diseases or viral infections

Related ICD-10 Codes

Primary Codes
Z11.59
Encounter for screening for other viral diseases
B17.1
Acute Hepatitis C
Ancillary Codes
Z72.89
Differential Codes
Z11.9
Z11.59
specifically for Hepatitis C screening, not
Z11.9
.

Related CPT Codes

CPT codes will be available in a future update.

Specialty Focus

Primary Specialty

Primary Care

Specialty Applications

  • Adults aged 18-79, especially those with risk factors
  • Primary care settings, outpatient clinics

Coding Complexity

High Complexity

This diagnosis requires careful attention to:

  • Comprehensive clinical documentation
  • Accurate code selection based on clinical criteria
  • Proper exclusion considerations
  • Specialty-specific coding guidelines

Documentation

Documentation Templates

Billing Information

Billing Considerations

  • Ensure proper documentation for billing
  • Verify code specificity requirements
  • Check for any additional codes needed
  • Review payer-specific guidelines

Common Issues

  • Insufficient clinical documentation
  • Incorrect code selection
  • Missing supporting diagnoses
  • Timing and frequency documentation

Frequently Asked Questions

What are the documentation requirements?

Document risk factors, test results, and follow-up plans.

What are the billing considerations?

Ensure proper coding for screening and follow-up tests.