Z13.40 ICD-10-CM Code: Encounter for screening for unspecified developmental delays
Compare with another codeCheck this code on a claim
Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.
Coding at a Glance
- Tabular directives
- 1 Excludes1 · 2 Excludes2
Billable · FY2027A valid, specific ICD-10-CM code, reportable for dates of service in FY2027.
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; the Instructions section marks which is which.
- Excludes1Never report with this code
- encounter for diagnostic examination-code to sign or symptom
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.
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 v44, 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 Z13.40 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
Notes without a marker are published on Z13.40 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 Z13
Excludes2 — Not Included Here
Conditions not covered by this code, but which may be reported alongside it when both are present.
- encounter for routine child health examination (Z00.12-) inherited from Z13.4Compare Z13.40 vs Z00.12 →
- examinations related to pregnancy and reproduction (Z30-Z36, Z39.-) inherited from Z00-Z13Compare Z13.40 vs Z30 →
Coder workflow for Z13.40
MedCoder structured workflow — derived from this code’s own official record
Before you code Z13.40
- Unspecified does not mean incorrect. When the record gives no greater specificity, Z13.40 may be the appropriate code. Check the record for detail that supports a more specific sibling. An unspecified code is for records that do not provide the detail a more specific code needs; a query, not an assumption, is the route to specificity (Guidelines I.A.9.b, I.B.18).
See the relationships section · Guide: Other vs unspecified (NEC vs NOS) →
- 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).
- Check the Excludes1 note: if the documentation supports a condition named there, do not simply proceed with Z13.40. Excludes1 conditions are not reported together with this code unless the record shows they are unrelated (Guidelines I.A.12.a).
Choose the right path
- Does the record document the detail a more specific sibling code needs?
Yes → Review the specific siblings in this subcategory.
No → Continue — Z13.40 is appropriate when the documentation goes no further. - Does the documentation support a condition named in Z13.40’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 Z13.40. 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 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).
- Any detail beyond this code’s title
- What the record states that a more specific sibling code would capture — or its absence, which itself supports the unspecified code.
Official instructions as workflow
Excludes1 — check before selecting Z13.40(1 note)
Coding workflow: If the documentation supports a condition named in this note, do not simply proceed with Z13.40: 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 Z13.40(2 notes)
Coding workflow: The conditions named in this note are not included in Z13.40. When the record documents both, both may be reported; the note is a boundary, not a prohibition.
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: The provider documents the condition in the terms of this code’s title and records no further detail.
Coding question: Is a more specific sibling code supportable?
Path: Review the specific siblings in this subcategory and what each requires the record to state.
Reason: A more specific code needs documentation of the distinguishing element; without it the unspecified code is appropriate, and a provider query is the route to specificity (Guidelines I.A.9.b, I.B.18).
Documentation: Both the condition Z13.40 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).
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.
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
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 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
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-derived relationships — computed from published CMS and AHRQ datasets
Other codes that name Z13.40 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 Z13.-), Z01 — Encounter for other special examination without complaint, suspected or reported diagnosis (via Z13.-).
These codes’ tabular lists name this diagnosis as distinct — both may be reported when both are documented.
MS-DRG Grouper Relationships (FY2027)
Potential MS-DRG participation — not a DRG assignment.
FY2027 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):FAC018 — Screening for neurocognitive or neurodevelopmental condition (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 (Screening for neurocognitive or neurodevelopmental condition).
Z13.4 — Encounter for screening for certain developmental disorders in childhood, Z13.41 — Encounter for autism screening, Z13.42 — Encounter for screening for global developmental delays (milestones), Z13.49 — Encounter for screening for other developmental delays
Same Index main term, other category
The ICD-10-CM Index to Diseases and Injuries files this code under the main term “Screening”; these codes share that main term but sit in a different category of the Tabular List.
Z12.10 — Encounter for screening for malignant neoplasm of intestinal tract, unspecified (neoplasm, intestinal tract), Z12.11 — Encounter for screening for malignant neoplasm of colon (colonoscopy), Z12.12 — Encounter for screening for malignant neoplasm of rectum (neoplasm, rectum), Z12.13 — Encounter for screening for malignant neoplasm of small intestine (neoplasm, small intestine), Z12.2 — Encounter for screening for malignant neoplasm of respiratory organs (neoplasm, lung), Z12.31 — Encounter for screening mammogram for malignant neoplasm of breast (neoplasm, breast, routine mammogram), Z12.39 — Encounter for other screening for malignant neoplasm of breast (neoplasm, breast), Z12.4 — Encounter for screening for malignant neoplasm of cervix (neoplasm, cervix), Z12.5 — Encounter for screening for malignant neoplasm of prostate (neoplasm, prostate), Z12.6 — Encounter for screening for malignant neoplasm of bladder (neoplasm, bladder), Z12.71 — Encounter for screening for malignant neoplasm of testis (neoplasm, genitourinary organs NEC, testis), Z12.72 — Encounter for screening for malignant neoplasm of vagina (neoplasm, genitourinary organs NEC, vagina), Z12.73 — Encounter for screening for malignant neoplasm of ovary (neoplasm, genitourinary organs NEC, ovary), Z12.79 — Encounter for screening for malignant neoplasm of other genitourinary organs (neoplasm, genitourinary organs NEC), Z12.81 — Encounter for screening for malignant neoplasm of oral cavity (neoplasm, oral cavity), Z12.82 — Encounter for screening for malignant neoplasm of nervous system (neoplasm, nervous system), Z12.83 — Encounter for screening for malignant neoplasm of skin (neoplasm, skin), Z12.89 — Encounter for screening for malignant neoplasm of other sites (leukemia), Z12.9 — Encounter for screening for malignant neoplasm, site unspecified (neoplasm), Z36.9 — Encounter for antenatal screening, unspecified (prenatal, of mother), +15 more
Contextual Map
Every relationship of Z13.40 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 Z13.40 with these 2 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-fy2027
- Z00-Z13 — Persons encountering health services for examinations[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2027
Referenced by Excludes2 notes
- Z00 — Encounter for general examination without complaint, suspected or reported diagnosis[Excludes2](via Z13.-): “special screening examinations (Z11-Z13)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2027
- Z01 — Encounter for other special examination without complaint, suspected or reported diagnosis[Excludes2](via Z13.-): “screening examinations (Z11-Z13)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2027
Clinical classification (CCSR)
- FAC018 — Screening for neurocognitive or neurodevelopmental condition[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) · FY2027
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. 1,258 same-MDC procedures group here; browse them on the MDC page.”— CMS MS-DRG Definitions Manual · FY2027
Index entries
- Screening (for), developmental, delays[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027
- Screening (for), disease or disorder, developmental delays[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027
Nearest codes (39)
- Z13 — Encounter for screening for other diseases and disorders[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2027
- Z13.0 — Encounter for screening for diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2027
- Z13.1 — Encounter for screening for diabetes mellitus[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2027
- Z13.2 — Encounter for screening for nutritional, metabolic and other endocrine disorders[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2027
- Z13.21 — Encounter for screening for nutritional disorder[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2027
- Z13.22 — Encounter for screening for metabolic disorder[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2027
- Z13.220 — Encounter for screening for lipoid disorders[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2027
- Z13.228 — Encounter for screening for other metabolic disorders[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2027
- and 31 more
Change history
- FY2019 — Added to the code set[Change history]— CMS release files (code change ledger) · icd10cm-fy2019
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.
Indexed Clinical Terms (2)
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.
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
- 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 — v44 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 20, 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. "Z13.40 — Encounter for screening for unspecified developmental delays." ICD-10-CM FY2027. https://medcoder.ai/icd10/code/z13.40-encounter-for-screening-for-unspecified-developmental-delays
Change history
- FY2019 — October 1, 2018Added to the code setEncounter for screening for unspecified developmental delaysFY2019 changes
Nearest Codes in This Family
Official ICD-10-CM classifications closest to Z13.40 in its code family, with their registry titles.
- Z13.30 — Encounter for screening examination for mental health and behavioral disorders, unspecified
- Z13.31 — Encounter for screening for depression
- Z13.32 — Encounter for screening for maternal depression
- Z13.39 — Encounter for screening examination for other mental health and behavioral disorders
- Z13.4 — Encounter for screening for certain developmental disorders in childhood
- Z13.41 — Encounter for autism screening
- Z13.42 — Encounter for screening for global developmental delays (milestones)
- Z13.49 — Encounter for screening for other developmental delays
- Z13.5 — Encounter for screening for eye and ear disorders
- Z13.6 — Encounter for screening for cardiovascular disorders