Z02.6 — Encounter for examination for insurance purposes
Is Z02.6 billable?
Yes — Z02.6 is billable for FY2027. Z02.6 is a valid, billable ICD-10-CM code at the highest level of specificity in its branch. Z02.6 may be submitted for encounters from October 1, 2026 through September 30, 2027.
Z02.6 at a glance
| Code | Z02.6 |
|---|---|
| Description | Encounter for examination for insurance purposes |
| Billable | Yes |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
What Medicare edits apply to Z02.6?
The Medicare Code Editor screens inpatient claims before they are grouped. These edits name Z02.6 directly.
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 Z02.6 group to?
Z02.6 sits in MDC 15 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.
- 795Normal Newbornmedical
How is Z02.6 listed in the Alphabetic Index?
These are the routes through the Alphabetic Index that lead to Z02.6. They show the wording a clinician may have documented, which often differs from the Tabular description.
- Examination › medical › insurance purposes (for) (following) (general) (of) (routine)
- Encounter › administrative purpose only › examination for › insurance (with health service) (for)
Excludes2 — not included here — inherited from Z00-Z13
The conditions below are not part of Z02.6, but a patient may have both at the same time. When documentation supports it, Z02.6 and the excluded code may both be reported.
How long has Z02.6 existed?
Z02.6 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 codes are confused with Z02.6?
ICD-10-CM declares these codes mutually exclusive with Z02.6 — exactly one of each pair can be correct for a given encounter.
Which conditions are coded to Z02.6?
What other codes are in the Z02 family? (9)
- Z02.0Encounter for examination for admission to educational institution
- Z02.1Encounter for pre-employment examination
- Z02.2Encounter for examination for admission to residential institution
- Z02.3Encounter for examination for recruitment to armed forces
- Z02.4Encounter for examination for driving license
- Z02.5Encounter for examination for participation in sport
- Z02.7Encounter for issue of medical certificatenot billable
- Z02.8Encounter for other administrative examinationsnot billable
- Z02.9Encounter for administrative examinations, unspecified