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v1.0.0
ICD-10 Guide
ICD-10 CodesZ11.6

Z11.6

Encounter for screening for other protozoal diseases and helminthiases

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

Code Description

ICD-10 Z11.6 is a billable code used to indicate a diagnosis of encounter for screening for other protozoal diseases and helminthiases.

Key Diagnostic Point:

Z11.6 is used to indicate an encounter for screening for protozoal diseases and helminthiases, which are parasitic infections that can significantly impact health, particularly in vulnerable populations. Screening for these conditions is essential in preventive care, especially in areas with high prevalence or among individuals with risk factors such as immunocompromised states, travel to endemic regions, or exposure to contaminated water or food. Social determinants of health, including socioeconomic status, access to healthcare, and education, play a critical role in the likelihood of screening and subsequent treatment. Preventive care through screening can lead to early detection and management of these diseases, reducing morbidity and improving health outcomes. This code is particularly relevant in primary care and public health settings, where proactive health measures are emphasized.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of protozoal diseases and helminthiases requiring specific documentation.
  • Need for thorough patient history to identify risk factors.
  • Potential overlap with other Z codes related to screening.
  • Documentation of social determinants influencing health status.

Audit Risk Factors

  • Inadequate documentation of patient history and risk factors.
  • Failure to link screening to appropriate preventive services.
  • Misuse of the code for symptomatic patients rather than screening.
  • Inconsistent application of screening guidelines across providers.

Specialty Focus

Medical Specialties

Primary Care

Documentation Requirements

Document patient history, risk factors, and rationale for screening.

Common Clinical Scenarios

Routine checkups where screening for parasitic infections is indicated based on travel history or exposure.

Billing Considerations

Consider social determinants such as living conditions, access to clean water, and healthcare access.

Public Health

Documentation Requirements

Population health data, surveillance reports, and community health assessments.

Common Clinical Scenarios

Community screenings in high-risk areas or during outbreaks.

Billing Considerations

Focus on tracking health disparities and ensuring equitable access to screening.

Coding Guidelines

Inclusion Criteria

Use Z11.6 When
  • Z codes are used when a patient is not currently ill but is seeking preventive services
  • 6 should be sequenced appropriately, often as a primary diagnosis when the encounter is solely for screening
  • Payer requirements may vary, so it is essential to verify coverage for preventive screenings

Exclusion Criteria

Do NOT use Z11.6 When
No specific exclusions found.

Related CPT Codes

87449CPT Code

Infectious agent detection by nucleic acid (DNA or RNA); protozoa, amplified probe technique.

Clinical Scenario

Used in conjunction with Z11.6 when screening for specific protozoal infections.

Documentation Requirements

Document the reason for the test and any relevant patient history.

Specialty Considerations

Primary care providers should ensure comprehensive documentation of risk factors.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for greater specificity in coding for screening encounters, enabling better tracking of health outcomes related to protozoal diseases and helminthiases.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for greater specificity in coding for screening encounters, enabling better tracking of health outcomes related to protozoal diseases and helminthiases.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for greater specificity in coding for screening encounters, enabling better tracking of health outcomes related to protozoal diseases and helminthiases.

Resources

Clinical References

  • •
    CDC Guidelines for Screening for Parasitic Infections

Coding & Billing References

  • •
    CDC Guidelines for Screening for Parasitic Infections

Frequently Asked Questions

When should Z11.6 be used?

Z11.6 should be used when a patient is screened for protozoal diseases and helminthiases as part of preventive care, particularly in the presence of risk factors such as travel history or exposure to contaminated environments.