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ICD-10/Z05.6

Z05.6 ICD-10-CM Code: Observation and evaluation of newborn for suspected genitourinary condition ruled out

Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.

Inpatient Payment Groups (MS-DRG)

MS-DRGs this diagnosis helps define, as principal or secondary, per the CMS ICD-10-CM/PCS MS-DRG Definitions Manual v43.0, Appendix B.

  • MS-DRG 795 — NORMAL NEWBORN (MDC 15)
  • MS-DRG 951 — OTHER FACTORS INFLUENCING HEALTH STATUS (MDC 23)

A diagnosis appearing in a group's logic does not by itself determine the DRG assigned to a stay; the grouper uses the full claim.

Official Registry Overview & Definition

Observation and evaluation of newborn for suspected genitourinary condition ruled out is a billable ICD-10-CM diagnosis code (Z05.6).

Official Tabular Instructional Notes

Sequencing, inclusion, and exclusion notes published for Z05.6 in the official ICD-10-CM tabular list.

Excludes2 — Not Included Here

Conditions not covered by this code, but which may be reported alongside it when both are present.

Change history

  • FY2017 — 2016-10-01
    Added to the code set
    Observation and evaluation of newborn for suspected genitourinary condition ruled out
    FY2017 changes

Verify Before Coding

  • Age-restricted: the Medicare Code Editor lists this as a perinatal/newborn (age 0 only) diagnosis; other ages are presumed incorrect.

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

Contextual Map

Every relationship of Z05.6 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.

Hierarchy

  • Z00-Z99 — Chapter 21: Factors Influencing Health Status and Contact with Health Services (Z00-Z99) (Z00-Z99) [Hierarchy]
  • Z00-Z13 — Persons encountering health services for examinations [Hierarchy]

Referenced by Excludes1 notes

  • Z03 — Encounter for medical observation for suspected diseases and conditions ruled out [Excludes1](via Z05.-): “encounter for observation and evaluation of newborn for suspected diseases and conditions ruled out (Z05.-)” · check together

Referenced by Excludes2 notes

  • P00 — Newborn affected by maternal conditions that may be unrelated to present pregnancy [Excludes2](via Z05.-): “encounter for observation of newborn for suspected diseases and conditions ruled out (Z05.-)” · check together
  • P01 — Newborn affected by maternal complications of pregnancy [Excludes2](via Z05.-): “encounter for observation of newborn for suspected diseases and conditions ruled out (Z05.-)” · check together
  • P02 — Newborn affected by complications of placenta, cord and membranes [Excludes2](via Z05.-): “encounter for observation of newborn for suspected diseases and conditions ruled out (Z05.-)” · check together
  • P03 — Newborn affected by other complications of labor and delivery [Excludes2](via Z05.-): “encounter for observation of newborn for suspected diseases and conditions ruled out (Z05.-)” · check together
  • P04 — Newborn affected by noxious substances transmitted via placenta or breast milk [Excludes2](via Z05.-): “encounter for observation of newborn for suspected diseases and conditions ruled out (Z05.-)” · check together

Clinical classification (CCSR)

  • FAC003 — Encounter for observation and examination for conditions ruled out (excludes infectious disease, neoplasm, mental disorders) [CCSR]

Potential MS-DRG

  • DRG 795 — NORMAL NEWBORN [MS-DRG]: “NORMAL NEWBORN (MDC 15)”
  • DRG 951 — OTHER FACTORS INFLUENCING HEALTH STATUS [MS-DRG]: “OTHER FACTORS INFLUENCING HEALTH STATUS (MDC 23)”

MDC crossing · procedures (1235)

  • MDC 15 — Newborns and Other Neonates with Conditions Originating in Perinatal Period [MDC crossing]: “Newborns and Other Neonates with Conditions Originating in Perinatal Period — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs.”
  • MDC 23 — Factors Influencing Health Status and Other Contacts with Health Services [MDC crossing]: “Factors Influencing Health Status and Other Contacts with Health Services — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs.”
  • and 1235 more

Index entries

  • Observation (following) (for) (without need for further medical care), newborn (for), suspected condition, related to exposure from the mother or birth process, ruled out, genitourinary[Index term]

Nearest codes (18)

  • Z05 — Encounter for observation and evaluation of newborn for suspected diseases and conditions ruled out [Sibling]
  • Z05.0 — Observation and evaluation of newborn for suspected cardiac condition ruled out [Sibling]
  • Z05.1 — Observation and evaluation of newborn for suspected infectious condition ruled out [Sibling]
  • Z05.2 — Observation and evaluation of newborn for suspected neurological condition ruled out [Sibling]
  • Z05.3 — Observation and evaluation of newborn for suspected respiratory condition ruled out [Sibling]
  • Z05.4 — Observation and evaluation of newborn for suspected genetic, metabolic or immunologic condition ruled out [Sibling]
  • Z05.41 — Observation and evaluation of newborn for suspected genetic condition ruled out [Sibling]
  • Z05.42 — Observation and evaluation of newborn for suspected metabolic condition ruled out [Sibling]
  • and 10 more

Change history

  • FY2017 — Added to the code set [Change history]

Referenced by Other Codes

Clinical classification (AHRQ CCSR):FAC003 — Encounter for observation and examination for conditions ruled out (excludes infectious disease, neoplasm, mental disorders) (default).

Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.

Potential MS-DRG Relationships (FY2026)

Not on the CMS CC/MCC list — as a secondary diagnosis this code does not change MS-DRG severity.

Named in the grouper logic of 2 MS-DRGs: DRG 795 (MDC 15), DRG 951 (MDC 23).

From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.

Official ICD-10-CM tabular notes on other codes that name Z05.6 or its code family.

1 Excludes1 notes: Z03 (via Z05.-).

5 Excludes2 notes: P00 (via Z05.-), P01 (via Z05.-), P02 (via Z05.-), P03 (via Z05.-), P04 (via Z05.-).

Nearest Codes in This Family

Official ICD-10-CM classifications closest to Z05.6 in its code family, with their registry titles.

  • Z05.4 — Observation and evaluation of newborn for suspected genetic, metabolic or immunologic condition ruled out
  • Z05.41 — Observation and evaluation of newborn for suspected genetic condition ruled out
  • Z05.42 — Observation and evaluation of newborn for suspected metabolic condition ruled out
  • Z05.43 — Observation and evaluation of newborn for suspected immunologic condition ruled out
  • Z05.5 — Observation and evaluation of newborn for suspected gastrointestinal condition ruled out
  • Z05.7 — Observation and evaluation of newborn for suspected skin, subcutaneous, musculoskeletal and connective tissue condition ruled out
  • Z05.71 — Observation and evaluation of newborn for suspected skin and subcutaneous tissue condition ruled out
  • Z05.72 — Observation and evaluation of newborn for suspected musculoskeletal condition ruled out
  • Z05.73 — Observation and evaluation of newborn for suspected connective tissue condition ruled out
  • Z05.8 — Observation and evaluation of newborn for other specified suspected condition ruled out

View all codes in the Z05 family

Indexed Clinical Terms (1)

Clinical term phrases from the official ICD-10-CM Index to Diseases and Injuries that map to this code.

  • Observation (following) (for) (without need for further medical care), newborn (for), suspected condition, related to exposure from the mother or birth process, ruled out, genitourinary