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Z16 ICD-10-CM Code: Resistance to antimicrobial drugs

Compare with another code for Z16Check this code on a claim

Billing Status: NO. This is a non-billable ICD-10-CM code: report a more specific billable code beneath it.

Coding at a Glance

Tabular directives
3 Excludes1 · 1 code-first instruction

Category · FY2027A non-billable heading in the tabular list: report a more specific code beneath it.

What you need to know

Source: CMS/NCHS Official ICD-10-CM tabular notes, quoted. From the CMS/NCHS tabular list for the release in force. A note the category or block publishes applies to this code too, and is marked with where it comes from.

Code firstSequence the underlying condition before this code
  • the infection
Excludes1Not reported with this code unless documented as unrelated
  • Methicillin resistant Staphylococcus aureus infection (A49.02)
  • Methicillin resistant Staphylococcus aureus pneumonia (J15.212)
  • Sepsis due to Methicillin resistant Staphylococcus aureus (A41.02)

Where it sits Source: CMS/NCHS

Under:Chapter 21: Factors Influencing Health Status and Contact with Health Services

Codes under Z16 (3)

  • Z16.1Resistance to beta lactam antibioticsNot billable
  • Z16.2Resistance to other antibioticsNot billable
  • Z16.3Resistance to other antimicrobial drugsNot billable

Most relevant related codes MedCoder-derived

Read off the official notes above and this code’s own position in the tabular list. Which to report is a documentation question; Compare shows the two side by side.

CompareCheck ClaimView Related Codes

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for Z16 in the official ICD-10-CM tabular list, quoted as published.

Source: CMS/CDC — ICD-10-CM Tabular ListRelease: FY2027Effective: October 1, 2026

Trace:FY2027 changesChange historyRelease, file and checksum

Excludes1 — Not Coded Here

Conditions generally not reported together with this code (Excludes1) -- an error unless the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).

Code First

Underlying conditions that must be sequenced before this code.

  • the infection

Coder workflow for Z16

MedCoder structured workflow — derived from this code’s own official record

Before you code Z16

  1. Z16 is not reportable as written. Select the more specific code beneath it that the documentation supports. Codes are reported to the highest level of specificity the classification provides (Guidelines I.B.2).

    ReviewZ16.1, Z16.2, Z16.3

    See the relationships section · Guide: How to choose an ICD-10-CM code →

  2. Confirm the reason for the encounter this Z code records: a status — a condition, carrier state or sequela that may affect care, distinct from a current complication of it. Check whether the code may be reported as first-listed or principal — some Z codes are limited to one position — and do not report a history or status code for a condition documented as current. Z code categories and their reporting positions (Guidelines I.C.21.c.3, I.C.21.c.15).

    Guide: Status codes (Z codes) →

  3. Check the Excludes1 note: if the documentation supports a condition named there, do not simply proceed with the code beneath Z16. Excludes1 conditions are not reported together with this code unless the record shows they are unrelated (Guidelines I.A.12.a).

    See the official tabular notes

Choose the right path

  1. Does the documentation support one of the more specific codes beneath Z16?
    Yes → Select that code and continue the checks below on its own page.
    No → Z16 cannot be reported as written. Where the codes beneath it include an unspecified code, that code applies when the record goes no further; otherwise query for the missing detail.

    ReviewZ16.1, Z16.2, Z16.3

  2. Does the documentation support a condition named in Z16’s Excludes1 note?
    Yes → Do not simply proceed: review the excluded code. Both are reported only when the record shows the two conditions are unrelated.
    No → Continue.

    ReviewA49.02, J15.212, A41.02

  3. Is the underlying (etiologic) condition the Code First note names documented?
    Yes → Sequence the underlying condition first, then the code beneath Z16.
    No → Continue; do not add an underlying condition the record does not document.

Report the code beneath Z16 that the documentation supports, not Z16 itself. Then confirm that code is valid for the date of service on its own page.

Documentation check

The provider’s diagnostic statement
Codes are assigned from the provider’s documented diagnosis, not from clinical criteria, test values or a medication list (Guidelines I.A.19).
The underlying (etiologic) condition
Named in the Code First note; sequenced before this code when documented (Guidelines I.A.13).
The reason for the encounter
Whether the code records the encounter’s purpose, a status, or a history — and whether it may be first-listed (Guidelines I.C.21.c).

Official instructions as workflow

  • Excludes1 — check before selecting Z16(3 notes)

    Coding workflow: If the documentation supports a condition named in this note, do not simply proceed with Z16: the two are not reported together. The one exception is when the record shows the two conditions are unrelated to each other.

    CompareA49.02, J15.212, A41.02

    See the official tabular notes · Guidelines I.A.12.a

  • Code First — sequencing check(1 note)

    Coding workflow: Check whether the underlying or etiologic condition the note names is documented. When it is, sequence it before Z16. Do not add an underlying condition the record does not document.

    See the official tabular notes · Guidelines I.A.13

Coding decision scenarios

Pattern scenarios for this code’s structure — decision rules, not clinical cases

Documentation: Both the condition Z16 describes and a condition named in its Excludes1 note are documented for the same encounter.

Coding question: Can both codes be reported?

Path: Review the Excludes1 note and the excluded code, and look for a provider statement on whether the two conditions are related.

Reason: Excludes1 means the two are not coded together; the exception is when the record shows the conditions are unrelated to each other (Guidelines I.A.12.a).

ReviewA49.02, J15.212, A41.02

Documentation: The underlying condition the Code First note names is documented alongside this condition.

Coding question: How are the two sequenced?

Path: Review the Code First note.

Reason: The underlying condition is sequenced first and the manifestation follows (Guidelines I.A.13).

Every row is derived from this code’s own record — its title, tabular notes, 7th-character family and same-category siblings — with fixed MedCoder wording; nothing is inferred about a patient. The official notes and guideline text are in the sections each row links to, and they control.

Don’t confuse Z16 with…

MedCoder analysis — pairs from this code’s official notes, distinctions written by MedCoder

The codes most likely to be picked instead of Z16 — named in its own official notes, or sharing its laterality or encounter family — with what separates them and which documentation moves the case. Each links to the full comparison.

  • A49.02— Excludes1 conflict (Excludes1 — generally not reported together)

    Not coded here — the tabular list excludes this pair for the same encounter.

    Not reported together with this code, except where the two conditions are documented as unrelated.

    What moves you there: Documentation of Methicillin resistant Staphylococcus aureus infection moves the case to A49.02; the two are not reported together unless documented as unrelated.

    Full comparison: Z16 vs A49.02 →

  • J15.212— Excludes1 conflict (Excludes1 — generally not reported together)

    Not coded here — the tabular list excludes this pair for the same encounter.

    Not reported together with this code, except where the two conditions are documented as unrelated.

    What moves you there: Documentation of Methicillin resistant Staphylococcus aureus pneumonia moves the case to J15.212; the two are not reported together unless documented as unrelated.

    Full comparison: Z16 vs J15.212 →

  • A41.02— Excludes1 conflict (Excludes1 — generally not reported together)

    Not coded here — the tabular list excludes this pair for the same encounter.

    Not reported together with this code, except where the two conditions are documented as unrelated.

    What moves you there: Documentation of Sepsis due to Methicillin resistant Staphylococcus aureus moves the case to A41.02; the two are not reported together unless documented as unrelated.

    Full comparison: Z16 vs A41.02 →

Relationships are read from this code's own official notes, its laterality siblings and its encounter family; the wording of each distinction is MedCoder editorial, and the documentation named in each “what moves you there” line is the official note phrase or sibling title itself. Source: CMS ICD-10-CM tabular instructional notes; ICD-10-CM Official Guidelines, Section I.A.12.a.

Coding context

Guidelines, coding notes, decision aids, relationships (with MS-DRG and CCSR classification), hierarchy, HCC, coverage and the context map: what a coder reaches for after the core. Each section names whether it is official source data, a MedCoder-derived relationship or MedCoder editorial.

Code Overview

Resistance to antimicrobial drugs is a non-billable ICD-10-CM category code (Z16). A more specific billable subcode must be selected for claims submission.

MedCoder summary Summary composed by MedCoder from this code's official ICD-10-CM record. The tabular instructional notes themselves appear verbatim below.

Official Coding Guidelines

Official source data — quoted verbatim from the CMS/NCHS Official Guidelines

Verbatim excerpts from the ICD-10-CM Official Guidelines for Coding and Reporting (CMS/NCHS) that govern this code.

Chapter 1: Certain Infectious and Parasitic Diseases (A00-B99), U07.1, U09.9 a. Human Immunodeficiency Virus (HIV) Infections 1) Code only confirmed cases

c. Infections resistant to antibiotics Many bacterial infections are resistant to current antibiotics. It is necessary to identify all infections documented as antibiotic resistant. Assign a code from category Z16, Resistance to antimicrobial drugs, following the infection code only if the infection code does not identify drug resistance.

Chapter 21: Factors influencing health status and contact with health services (Z00-Z99)

Codes from category Z15 should generally not be used as principal or first-listed codes. If the patient has the condition to which he/she is susceptible, and that condition is the reason for the encounter, the code for the current condition should be sequenced first. If the patient is being seen for follow-up after completed treatment for this condition, and the condition no longer exists, a follow-up code should be sequenced first, followed by the appropriate personal history and genetic susceptibility codes. If the purpose of the encounter is genetic counseling associated with procreative management, code Z31.5, Encounter for genetic counseling, should be assigned as the first-listed code, followed by a code from category Z15. Additional codes should be assigned for any applicable family or personal history. Z16 Resistance to antimicrobial drugs This category indicates that a patient has a condition that is resistant to antimicrobial drug treatment. Sequence the infection code first. Z17 Estrogen, and other hormones and factors receptor status Z18 Retained foreign body fragments Z19 Hormone sensitivity malignancy status Z21 Asymptomatic HIV infection status This code indicates that a patient has tested positive for HIV but has manifested no signs or symptoms of the disease. Z22 Carrier of infectious disease Carrier status indicates that a person harbors the specific organisms of a disease without manifest symptoms and is capable of transmitting the infection. Z28.3 Underimmunization status

Verify Before Coding

From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim in Claim Check.

Relationships & Classification

MedCoder-derived relationships — computed from published CMS and AHRQ datasets

Other codes that name Z16 or its code family, from the CMS ICD-10-CM tabular instructional notes. Tabular-note edges are stored at the code family level that carries each note.

Referenced by 11 Use Additional Code instructions: J09 — Influenza due to certain identified influenza viruses, J09-J18 — Influenza and pneumonia (J09-J18), J10 — Influenza due to other identified influenza virus, J11 — Influenza due to unidentified influenza virus, J12 — Viral pneumonia, not elsewhere classified, J13 — Pneumonia due to Streptococcus pneumoniae, J14 — Pneumonia due to Hemophilus influenzae, J15 — Bacterial pneumonia, not elsewhere classified, J16 — Pneumonia due to other infectious organisms, not elsewhere classified, J17 — Pneumonia in diseases classified elsewhere, J18 — Pneumonia, unspecified organism.

These codes instruct coders to additionally report this code when it applies.

Contextual Map

Every relationship of Z16 in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.

Run Z16 with these 11 related codes in Claim Check

Hierarchy

Excludes1

Referenced by Use Additional Code instructions (11)

Nearest codes (23)

Change history

  • FY2016 — In the code set at ICD-10-CM adoption [Change history]— CMS release files (code change ledger) · icd10cm-fy2016

Reference

Index terms and tables, published questions and FAQ, every source behind this page with its release and checksum, the date-of-service check and the complete change history.

Common coding questions

MedCoder editorial

Can Z16 be billed directly?

No. Z16 (Resistance to antimicrobial drugs) is a non-billable ICD-10-CM category code. A more specific billable subcode must be selected based on clinical documentation.

Sources for this page

Codes, titles, notes, index terms and mappings on this page are transcribed from the datasets below. Relationships MedCoder computed and text MedCoder wrote are labelled where they appear.

Code, title, tabular notes and index terms Official source data
CMS/CDC ICD-10-CM FY2027 tabular list, index and tables, effective October 1, 2026 Release, file and checksum · Publisher’s page
Coding guidelines Official source data
ICD-10-CM Official Guidelines for Coding and Reporting (FY2027), quoted by section Release, file and checksum · Publisher’s page
Claim edits Official source data
CMS Definitions of Medicare Code Edits — v44.0 (October 2026) Release, file and checksum · Publisher’s page
Change history and date-of-service validity Official source data
CMS ICD-10-CM release addenda, ingested release by release into the change ledger Release, file and checksum · Publisher’s page
Comparisons, relationships and the contextual map MedCoder-derived relationship
Computed by MedCoder from the tabular notes and tables above; every derived relationship is marked as derived where it appears
Summary and FAQ answers MedCoder editorial explanation
Written by MedCoder to explain the sources above: drafted with AI assistance, checked by a person against the release files, and labelled as MedCoder text where it appears. Not official text.

Current data releases:ICD-10-CM FY2027 · ICD-10-PCS FY2027 · HCPCS October 2026 · MS-DRG v44 · Medicare Code Editor v44.0 · NCCI PTP Q4 2026 · MUE Q4 2026 · NCD code lists 2026-01 · LCD export September 28, 2026 · All releases and sources

Labels on this page: Official source data · MedCoder-derived relationship · MedCoder editorial explanation. How to read the labels · All data sources and release dates · CMS coding rules

Cite this page

Reference this page in a research guide, syllabus or article. The release is included because code content changes each year.

MedCoder.ai. "Z16 — Resistance to antimicrobial drugs." ICD-10-CM FY2027. https://medcoder.ai/icd10/code/z16-resistance-to-antimicrobial-drugs

Change history

  • FY2016 — October 1, 2015
    In the code set at ICD-10-CM adoption
    Resistance to antimicrobial drugs

No changes since FY2016 — additions, deletions, description changes and billable-status changes are tracked through FY2027, and none are recorded for this code. Note changes are tracked from FY2027 only.

Nearest Codes in This Family

Official ICD-10-CM classifications closest to Z16 in its code family, with their registry titles.