Z36.0 Encounter for antenatal screening for chromosomal anomalies

BillableNo payment HCCChapter 21

Check coverage with this diagnosis

Instructional notes

Chapter 21

Notes

Z codes represent reasons for encounters. A corresponding procedure code must accompany a Z code if a procedure is performed. Categories Z00-Z99 are provided for occasions when circumstances other than a disease, injury or external cause classifiable to categories A00-Y89 are recorded as 'diagnoses' or 'problems'. This can arise in two main ways:
(a) When a person who may or may not be sick encounters the health services for some specific purpose, such as to receive limited care or service for a current condition, to donate an organ or tissue, to receive prophylactic vaccination (immunization), or to discuss a problem which is in itself not a disease or injury.
(b) When some circumstance or problem is present which influences the person's health status but is not in itself a current illness or injury.

Z36

Excludes1Not coded here: never report with this code, except when the two conditions are unrelated.

diagnostic examination- code to sign or symptom
encounter for suspected maternal and fetal conditions ruled out (Z03.7-)
suspected fetal condition affecting management of pregnancy - code to condition in Chapter 15

Excludes2Not included here: the patient may have both; report both when both are present.

abnormal findings on antenatal screening of mother (O28.-)
genetic counseling and testing (Z31.43-, Z31.5)
routine prenatal care (Z34)

Includes

Encounter for placental sample (taken vaginally)
Screening is the testing for disease or disease precursors in asymptomatic individuals so that early detection and treatment can be provided for those who test positive for the disease.

This code

Inclusion terms

Encounter for antenatal screening for Down syndrome
Encounter for antenatal screening for fetal aneuploidy
Encounter for antenatal screening for Patau syndrome
Encounter for antenatal screening for Trisomy 13
Encounter for antenatal screening for Trisomy 21

Chapter 21: Factors influencing health status and contact with health services · Z30-Z39 Persons encountering health services in circumstances related to reproduction (Z30-Z39)

Source: ICD-10-CM FY 2027 code descriptions and tabular list (CMS and CDC National Center for Health Statistics), effective 2026-10-01 through 2027-09-30 · CMS ICD-10 files. HCC mapping: CMS-HCC V28, payment year 2027. As of 2026-11-04.

Coverage and payment depend on the claim details; confirm with the Medicare Administrative Contractor.