ICDcodes.org
FY2027

Z02.5 — Encounter for examination for participation in sport

Billable

Is Z02.5 billable?

Yes — Z02.5 is billable for FY2027. Z02.5 is a valid, billable ICD-10-CM code at the highest level of specificity in its branch. Z02.5 may be submitted for encounters from October 1, 2026 through September 30, 2027.

Z02.5 at a glance

CodeZ02.5
DescriptionEncounter for examination for participation in sport
BillableYes
Code setICD-10-CM FY2027
Valid for encountersOctober 1, 2026 – September 30, 2027

What Medicare edits apply to Z02.5?

The Medicare Code Editor screens inpatient claims before they are grouped. These edits name Z02.5 directly.

Cannot be a principal diagnosis — MCE edit 9

CMS will reject this code as the principal diagnosis on an inpatient claim. It describes something other than the condition chiefly responsible for the admission.

Which MS-DRGs does Z02.5 group to?

Z02.5 sits in MDC 23 and helps define the logic of 1 MS-DRG (version 44, FY2027). Which one a stay actually groups to also depends on procedures and secondary diagnoses.

  • 951Other Factors Influencing Health Statusmedical

How is Z02.5 listed in the Alphabetic Index?

These are the routes through the Alphabetic Index that lead to Z02.5. They show the wording a clinician may have documented, which often differs from the Tabular description.

  • Examination › medical › participation in sport (for) (following) (general) (of) (routine)
  • Examination › medical › sport competition (for) (following) (general) (of) (routine)
  • Examination › physical › sports (for) (following) (general) (of) (routine)
  • Encounter › administrative purpose only › examination for › sports (with health service) (for)

Excludes1 — never code together

The conditions below can never be reported together with Z02.5 on the same claim. An Excludes1 note means the two conditions cannot occur in the same patient, so reporting both is a coding error.

  • blood-alcohol and blood-drug test (Z02.83)

Excludes2 — not included here — inherited from Z00-Z13

The conditions below are not part of Z02.5, but a patient may have both at the same time. When documentation supports it, Z02.5 and the excluded code may both be reported.

  • examinations related to pregnancy and reproduction (Z30-Z36, Z39.-)

How long has Z02.5 existed?

Z02.5 has been in ICD-10-CM since at least FY2016, the earliest fiscal year on record here.

Derived from the official order files for FY2016–FY2026. FY2017 and FY2020 publish no order file, so those years are not covered.

Which conditions are coded to Z02.5?

What other codes are in the Z02 family? (9)