Z04.42 Encounter for examination and observation following alleged child rape

Billable ICD-10-CM code, FY2026.

Applicable to

• Suspected child rape, ruled out
• Suspected child sexual abuse, ruled out

Applies from Z04 Encounter for examination and observation for other reasons

Includes

• encounter for examination for medicolegal reasons
• This category is to be used when a person without a diagnosis is suspected of having an abnormal condition, without signs or symptoms, which requires study, but after examination and observation, is ruled-out. This category is also for use for administrative and legal observation status.

Applies from Z04.4 Encounter for examination and observation following alleged rape

Applicable to

• Encounter for examination and observation of victim following alleged rape
• Encounter for examination and observation of victim following alleged sexual abuse

MS-DRG index

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

Approximate ICD-9-CM (GEMs)

• V71.5 Observation following alleged rape or seduction (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.

Code annotations containing back-references to Z04.42

Back-references to Z04.42

• Type 1 Excludes: T76 Adult and child abuse, neglect and other maltreatment, suspected ("suspected child sexual abuse, ruled out (Z04.42)")
• Type 2 Excludes: Z02.84 Encounter for child welfare exam ("encounter for examination and observation for alleged child rape (Z04.42)")
• Type 1 Excludes: Z04.72 Encounter for examination and observation following alleged child physical abuse ("encounter for examination and observation following alleged child sexual abuse (Z04.42)")

Diagnosis Index entries for Z04.42

• Examination (for) (following) (general) (of) (routine) › alleged rape or sexual assault (victim), ruled out › child
• Observation (following) (for) (without need for further medical care) › alleged rape or sexual assault (victim), ruled out › child
• Rape › alleged, observation or examination, ruled out › child

Nearby codes

• Z04.1 Encounter for examination and observation following transport accident
• Z04.2 Encounter for examination and observation following work accident
• Z04.3 Encounter for examination and observation following other accident
• Z04.4 Encounter for examination and observation following alleged rape
• Z04.41 Encounter for examination and observation following alleged adult rape
• Z04.42 Encounter for examination and observation following alleged child rape (this code)
• Z04.6 Encounter for general psychiatric examination, requested by authority
• Z04.7 Encounter for examination and observation following alleged physical abuse
• Z04.71 Encounter for examination and observation following alleged adult physical abuse
• Z04.72 Encounter for examination and observation following alleged child physical abuse
• Z04.8 Encounter for examination and observation for other specified reasons