Z00.121 Encounter for routine child health 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 Z00.12 Encounter for routine child health examination

Applicable to

• Health check (routine) for child over 28 days old
• Immunizations appropriate for age
• Routine developmental screening of infant or child
• Routine vision and hearing testing

Excludes1 (never code together)

• health check for child under 29 days old (Z00.11-)
• health supervision of foundling or other healthy infant or child (Z76.1-Z76.2)
• newborn health examination (Z00.11-)

MS-DRG index

Defines the logic of DRG(s) 795 in MDC 15.

Approximate ICD-9-CM (GEMs)

• V20.2 Routine infant or child health check (approximate)

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

• Pediatric diagnoses (age 0 through 17): Age conflict edit. These diagnoses are clinically expected only in patients age 0 through 17.
• 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 Z00.121

Back-references to Z00.12

• Type 1 Excludes: Z00.0 Encounter for general adult medical examination ("general health check-up of infant or child (Z00.12.-)")
• Type 1 Excludes: Z00.11 Newborn health examination ("health check for child over 28 days old (Z00.12-)")
• Type 2 Excludes: Z13.4 Encounter for screening for certain developmental disorders in childhood ("encounter for routine child health examination (Z00.12-)")

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 Z00.121

• Admission (for) › examination at health care facility (adult) › hearing › infant or child (over 28 days old) › with abnormal findings
• Admission (for) › examination at health care facility (adult) › vision › infant or child (over 28 days old) › with abnormal findings
• Admission (for) › vision examination › infant or child (over 28 days old) › with abnormal findings
• Examination (for) (following) (general) (of) (routine) › child (over 28 days old) › with abnormal findings
• Examination (for) (following) (general) (of) (routine) › hearing › infant or child (over 28 days old) › with abnormal findings
• Examination (for) (following) (general) (of) (routine) › vision › infant or child (over 28 days old) › with abnormal findings
• Hearing examination › infant or child (over 28 days old) › with abnormal findings
• Immunization › appropriate for age › child (over 28 days old) › with abnormal findings
• Screening (for) › infant or child (over 28 days old) › with abnormal findings
• Test, tests, testing (for) › hearing › infant or child (over 28 days old) › with abnormal findings
• Test, tests, testing (for) › vision › infant or child (over 28 days old) › with abnormal findings

Nearby codes

• 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
• Z00.121 Encounter for routine child health examination with abnormal findings (this code)
• Z00.129 Encounter for routine child health examination without abnormal findings
• Z00.2 Encounter for examination for period of rapid growth in childhood
• Z00.3 Encounter for examination for adolescent development state
• Z00.5 Encounter for examination of potential donor of organ and tissue
• Z00.6 Encounter for examination for normal comparison and control in clinical research program