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

Coding at a Glance

Tabular directives: 1 Excludes1 · 3 Excludes2

Inpatient Payment Groups (MS-DRG)

Potential MS-DRG participation — not a DRG assignment.

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

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.

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for Z11.3 in the official ICD-10-CM tabular list, quoted as published.

Source: CMS/CDC — ICD-10-CM Tabular ListRelease: FY2026Effective: October 1, 2025

Notes without a marker are published on Z11.3 itself; “inherited from” names the category or block whose note applies here.

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).

encounter for diagnostic examination-code to sign or symptom

Source: inherited from Z11

Excludes2 — Not Included Here

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

encounter for screening for human immunodeficiency virus HIV
encounter for screening for human papillomavirus (Z11.51) Compare Z11.3 vs Z11.51 →
examinations related to pregnancy and reproduction (Z30-Z36, Z39.-) inherited from Z00-Z13Compare Z11.3 vs Z30 →

Coder workflow for Z11.3

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

Before you code Z11.3

Z11.3’s title joins a condition with an associated condition or complication. Confirm each component is documented. Where the classification presumes the link through the “with” convention, only a provider statement that the conditions are unrelated defeats it. A combination code is assigned only when it fully identifies the documented conditions; a required second code for the stage, type or manifestation is still reported when the notes ask for it (Guidelines I.B.9, I.A.15).
Guide: Combination codes →
Confirm the reason for the encounter this Z code records: a screening — testing for disease in a patient without signs or symptoms; a test ordered for a documented sign, symptom or diagnosis is diagnostic, not screening. 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.5, I.C.21.c.15).
Guide: Screening vs diagnostic →
Check the Excludes1 note: if the documentation supports a condition named there, do not simply proceed with Z11.3. 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

Does the documentation support a condition named in Z11.3’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.

Consider Z11.3. Then confirm the code is valid for the date of service in the Verify section.

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 associated condition or complication: Whether the associated condition the title names is documented; the “with” convention presumes some links, and a provider statement that the conditions are unrelated defeats it (Guidelines I.A.15).
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 Z11.3(1 note)
Coding workflow: If the documentation supports a condition named in this note, do not simply proceed with Z11.3: the two are not reported together. The one exception is when the record shows the two conditions are unrelated to each other.
See the official tabular notes · Guidelines I.A.12.a
Excludes2 — not part of Z11.3(3 notes)
Coding workflow: The conditions named in this note are not included in Z11.3. When the record documents both, both may be reported; the note is a boundary, not a prohibition.
CompareZ11.51, Z39
See the official tabular notes · Guidelines I.A.12.b

Coding decision scenarios

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

Documentation: Both the condition Z11.3 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).

Documentation: Only one of the components this code’s title joins is documented.

Coding question: Is Z11.3 supported?

Path: Review the code for the documented component on its own.

Reason: A combination code is assigned only when it fully identifies the documented conditions; otherwise the documented component takes its own code (Guidelines I.B.9).

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.

Code Overview

Encounter for screening for infections with a predominantly sexual mode of transmission is a billable ICD-10-CM diagnosis code (Z11.3).

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

Indexed Clinical Terms (7)

Official source data — entries quoted as published, in the Index’s own lookup phrasing

Clinical term phrases from the official ICD-10-CM Index to Diseases and Injuries that map to this code. These are alphabetic-index entries shown as the Index writes them — lookup phrasing, not necessarily the wording of a final diagnosis.

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

The screening Z codes/categories: Z11 Encounter for screening for infectious and parasitic diseases Z12 Encounter for screening for malignant neoplasms Z13 Encounter for screening for other diseases and disorders Except: Z13.9, Encounter for screening, unspecified Z36 Encounter for antenatal screening for mother

Don’t confuse Z11.3 with…

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

The codes most likely to be picked instead of Z11.3 — 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.

Z11.9— Specificity relationship (Review)
Overlapping diagnoses in the same category.
Overlapping codes in the same category — the documentation decides which is the more specific fit.
What moves you there: A record that documents no more than “Encounter for screening for infectious and parasitic diseases, unspecified” takes Z11.9; specificity in the record moves it back here.
Full comparison: Z11.3 vs Z11.9 →
Z11.51— Excludes2 relationship (Informational)
Distinct conditions — both may be reported.
A distinct condition — both may be reported when both are documented.
What moves you there: Documentation of encounter for screening for human papillomavirus adds Z11.51; it is not part of this code and both may be reported when both are documented.
Full comparison: Z11.3 vs Z11.51 →
Z30— Excludes2 relationship (Informational)
Distinct conditions — both may be reported.
A distinct condition — both may be reported when both are documented.
What moves you there: Documentation of examinations related to pregnancy and reproduction adds Z30; it is not part of this code and both may be reported when both are documented.
Full comparison: Z11.3 vs Z30 →
Z36— Excludes2 relationship (Informational)
Distinct conditions — both may be reported.
A distinct condition — both may be reported when both are documented.
What moves you there: Documentation of examinations related to pregnancy and reproduction adds Z36; it is not part of this code and both may be reported when both are documented.
Full comparison: Z11.3 vs Z36 →
Z39— Excludes2 relationship (Informational)
Distinct conditions — both may be reported.
A distinct condition — both may be reported when both are documented.
What moves you there: Documentation of examinations related to pregnancy and reproduction adds Z39; it is not part of this code and both may be reported when both are documented.
Full comparison: Z11.3 vs Z39 →

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.

Verify Before Coding

Principal-diagnosis restriction. The Medicare Code Editor lists this code as unacceptable as a principal diagnosis: it describes a circumstance influencing health status rather than a current illness or injury being treated. It is valid as a secondary diagnosis.

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 structured relationships — computed from published CMS and AHRQ datasets

Other codes that name Z11.3 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 2 Excludes2 notes: Z00 — Encounter for general examination without complaint, suspected or reported diagnosis (via Z11.-), Z01 — Encounter for other special examination without complaint, suspected or reported diagnosis (via Z11.-).

These codes’ tabular lists name this diagnosis as distinct — both may be reported when both are documented.

MS-DRG Grouper Relationships (FY2026)

Potential MS-DRG participation — not a DRG assignment.

FY2026 MS-DRG: not on the CMS CC/MCC list — as a secondary diagnosis this code does not change MS-DRG severity for that release.

Named in the grouper logic of 1 MS-DRG: DRG 951 (MDC 23).

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

Clinical classification (AHRQ CCSR):FAC016 — Exposure, encounters, screening or contact with infectious disease (default).

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

Related Codes

Principal diagnosis restriction (Medicare Code Editor)

Not acceptable as a principal diagnosis on an inpatient claim.

Same clinical category (CCSR)

AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical category (Exposure, encounters, screening or contact with infectious disease).

Same Index main term, other category

The ICD-10-CM Index to Diseases and Injuries files this code under the main terms “Screening”, “Test, tests, testing”; these codes share that main term but sit in a different category of the Tabular List.

Contextual Map

Every relationship of Z11.3 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 Z11.3 with these 4 related codes in Claim Check

Hierarchy

Z00-Z99 — Chapter 21: Factors Influencing Health Status and Contact with Health Services (Z00-Z99) (Z00-Z99)[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
Z00-Z13 — Persons encountering health services for examinations[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2026

Excludes2

Z11.4 — Encounter for screening for human immunodeficiency virus [HIV][Excludes2]: “encounter for screening for human immunodeficiency virus [HIV] (Z11.4)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
Z11.51 — Encounter for screening for human papillomavirus (HPV)[Excludes2]: “encounter for screening for human papillomavirus (Z11.51)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026

Referenced by Excludes2 notes

Z00 — Encounter for general examination without complaint, suspected or reported diagnosis[Excludes2](via Z11.-): “special screening examinations (Z11-Z13)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
Z01 — Encounter for other special examination without complaint, suspected or reported diagnosis[Excludes2](via Z11.-): “screening examinations (Z11-Z13)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026

Clinical classification (CCSR)

FAC016 — Exposure, encounters, screening or contact with infectious disease[CCSR]— AHRQ CCSR for ICD-10-CM Diagnoses (HCUP)

MS-DRG Grouper

DRG 951 — OTHER FACTORS INFLUENCING HEALTH STATUS[MS-DRG]: “OTHER FACTORS INFLUENCING HEALTH STATUS (MDC 23)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2026

MDC crossing

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. 1,235 same-MDC procedures group here; browse them on the MDC page.”— CMS MS-DRG Definitions Manual · FY2026

Index entries

Screening (for), disease or disorder, sexually-transmitted NEC[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
Screening (for), disease or disorder, venereal[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
Screening (for), gonorrhea[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
Screening (for), sexually-transmitted disease NEC[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
Screening (for), syphilis[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
Screening (for), venereal disease[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
Test, tests, testing (for), Wassermann[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026

Nearest codes (13)

Z11 — Encounter for screening for infectious and parasitic diseases[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
Z11.0 — Encounter for screening for intestinal infectious diseases[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
Z11.1 — Encounter for screening for respiratory tuberculosis[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
Z11.2 — Encounter for screening for other bacterial diseases[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
Z11.4 — Encounter for screening for human immunodeficiency virus [HIV][Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
Z11.5 — Encounter for screening for other viral diseases[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
Z11.51 — Encounter for screening for human papillomavirus (HPV)[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
Z11.52 — Encounter for screening for COVID-19[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
and 5 more

Change history

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

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 FY2026 tabular list, index and tables, effective October 1, 2025 Release, file and checksum · Publisher’s page
Coding guidelines Official source data: ICD-10-CM Official Guidelines for Coding and Reporting (FY2026), quoted by section Release, file and checksum · Publisher’s page
Claim edits Official source data: CMS Definitions of Medicare Code Edits — v43.1 (April 2026) Release, file and checksum · Publisher’s page
Inpatient payment groups Official source data: CMS MS-DRG Definitions Manual (incl. Appendix B diagnosis index, Appendix C CC/MCC list, Appendix E procedure index) and IPPS Final Rule tables — v43 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 structured 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 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.

Labels on this page: Official source data · MedCoder structured relationship · MedCoder explanation. How to read the labels · All data sources and release dates

Change history

FY2016 — October 1, 2015
In the code set at ICD-10-CM adoption
Encounter for screening for infections with a predominantly sexual mode of transmission

No changes since FY2016 — additions, deletions, description changes and billable-status changes are tracked through FY2027 (effective October 1, 2026), 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 Z11.3 in its code family, with their registry titles.

View all codes in the Z11 family

Z11.3 ICD-10-CM Code: Encounter for screening for infections with a predominantly sexual mode of transmission

Coding at a Glance

Inpatient Payment Groups (MS-DRG)

Coding instructions

Excludes1 — Not Coded Here

Excludes2 — Not Included Here

Coder workflow for Z11.3

Before you code Z11.3

Choose the right path

Documentation check

Official instructions as workflow

Coding decision scenarios

Code Overview

Indexed Clinical Terms (7)

Official Coding Guidelines

Don’t confuse Z11.3 with…

Verify Before Coding

Relationships & Classification

MS-DRG Grouper Relationships (FY2026)

Related Codes

Principal diagnosis restriction (Medicare Code Editor)

Same clinical category (CCSR)

Same Index main term, other category

Contextual Map

Hierarchy

Excludes2

Referenced by Excludes2 notes

Clinical classification (CCSR)

MS-DRG Grouper

MDC crossing

Index entries

Nearest codes (13)

Change history

Sources for this page

Change history

Nearest Codes in This Family