Z13.5 — Encounter for screening for eye and ear disorders

Billable

Is Z13.5 billable?

Yes — Z13.5 is billable for FY2027. Z13.5 is a valid, billable ICD-10-CM code at the highest level of specificity in its branch. Z13.5 may be submitted for encounters from October 1, 2026 through September 30, 2027.

Z13.5 at a glance

Code	Z13.5
Description	Encounter for screening for eye and ear disorders
Billable	Yes
Code set	ICD-10-CM FY2027
Valid for encounters	October 1, 2026 – September 30, 2027

What Medicare edits apply to Z13.5?

The Medicare Code Editor screens inpatient claims before they are grouped. These edits name Z13.5 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 Z13.5 group to?

Z13.5 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 Z13.5 listed in the Alphabetic Index?

These are the routes through the Alphabetic Index that lead to Z13.5. They show the wording a clinician may have documented, which often differs from the Tabular description.

Screening › cataract (for)
Screening › glaucoma (for)
Screening › congenital › eye disorder (for)
Screening › disease or disorder › ear (for)
Screening › disease or disorder › eye (for)

Excludes2 — not included here

The conditions below are not part of Z13.5, but a patient may have both at the same time. When documentation supports it, Z13.5 and the excluded code may both be reported.

encounter for general hearing examination (Z01.1-)
encounter for general vision examination (Z01.0-)

Excludes1 — never code together — inherited from Z13

The conditions below can never be reported together with Z13.5 on the same claim. An Excludes1 note means the two conditions cannot occur in the same patient, so reporting both is a coding error.

encounter for diagnostic examination-code to sign or symptom

Excludes2 — not included here — inherited from Z00-Z13

The conditions below are not part of Z13.5, but a patient may have both at the same time. When documentation supports it, Z13.5 and the excluded code may both be reported.

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

How long has Z13.5 existed?

Z13.5 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 Z13.5?

ICD-10 code for Screening