Z00.01 Encounter for general adult medical examination with abnormal findings

Billable ICD-10-CM code, FY2026. Exempt from present-on-admission (POA) reporting.

Use additional code

• code to identify abnormal findings

Applies from Z00 Encounter for general examination without complaint, suspected or reported diagnosis

Excludes1 (never code together)

• encounter for examination for administrative purposes (Z02.-)

Excludes2 (not included here)

• encounter for pre-procedural examinations (Z01.81-)
• special screening examinations (Z11-Z13)

Applies from Z00.0 Encounter for general adult medical examination

Applicable to

• Encounter for adult periodic examination (annual) (physical) and any associated laboratory and radiologic examinations

Excludes1 (never code together)

• encounter for examination of sign or symptom- code to sign or symptom
• general health check-up of infant or child (Z00.12.-)

MS-DRG index

Defines the logic of DRG(s) 951 in MDC 23.

Approximate ICD-9-CM (GEMs)

• V70.0 Routine general medical examination at a health care facility (approximate)

Medicare Code Edits (MCE v43.1 (April 2026))

• Adult diagnoses (age 15 through 124): Age conflict edit. These diagnoses are clinically expected only in patients age 15 through 124.
• Unacceptable principal diagnosis: These codes describe a circumstance which influences care but is not a current illness or injury, or capture only an underlying condition, and are unacceptable as principal diagnosis.

Code annotations containing back-references to Z00.01

Back-references to Z00.0

• Type 2 Excludes: Z01 Encounter for other special examination without complaint, suspected or reported diagnosis ("encounter for laboratory and radiologic examinations as a component of general medical examinations (Z00.0-)")

Back-references to Z00

• Type 1 Excludes: Z02.7 Encounter for issue of medical certificate ("encounter for general medical examination (Z00-Z01, Z02.0-Z02.6, Z02.8-Z02.9)")

Diagnosis Index entries for Z00.01

• Admission (for) › examination at health care facility (adult) › with abnormal findings
• Encounter (with health service) (for) › laboratory (as part of a general medical examination) › with abnormal findings
• Encounter (with health service) (for) › radiological (as part of a general medical examination) › with abnormal findings
• Encounter (with health service) (for) › X-ray of chest (as part of a general medical examination) › with abnormal findings
• Examination (for) (following) (general) (of) (routine) › with abnormal findings
• Examination (for) (following) (general) (of) (routine) › annual (adult) (periodic) (physical) › with abnormal findings
• Examination (for) (following) (general) (of) (routine) › laboratory (as part of a general medical examination) › with abnormal findings
• Examination (for) (following) (general) (of) (routine) › medical (adult) (for) (of) › with abnormal findings
• Examination (for) (following) (general) (of) (routine) › medical (adult) (for) (of) › general (adult) › with abnormal findings
• Examination (for) (following) (general) (of) (routine) › periodic (adult) (annual) (routine) › with abnormal findings
• Examination (for) (following) (general) (of) (routine) › radiological (as part of a general medical examination) › with abnormal findings
• Test, tests, testing (for) › laboratory (as part of a general medical examination) › with abnormal finding
• X-ray (of) › chest › routine (as part of a general medical examination) › with abnormal findings
• X-ray (of) › routine (as part of a general medical examination) › with abnormal findings

Nearby codes

• Z00 Encounter for general examination without complaint, suspected or reported diagnosis
• Z00.0 Encounter for general adult medical examination
• Z00.00 Encounter for general adult medical examination without abnormal findings
• Z00.01 Encounter for general adult medical examination with abnormal findings (this code)
• Z00.1 Encounter for newborn, infant and child health examinations
• Z00.11 Newborn health examination
• Z00.110 Health examination for newborn under 8 days old
• Z00.111 Health examination for newborn 8 to 28 days old
• Z00.12 Encounter for routine child health examination