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ICD-10-CM 2027 diagnosis code

Z04.2Encounter for examination and observation following work accident

✓ Billable / specific

Z04.2 is a valid, billable ICD-10-CM code for encounter for examination and observation following work accident. It can be reported on claims for dates of service from October 1, 2026 – September 30, 2027.Short description: Encounter for exam and observation following work accident

Code unchanged since ICD-10-CM took effect on October 1, 2015. Source: official FY2027 ICD-10-CM release from CDC/NCHS and CMS. Page updated September 29, 2026. About our data

About Z04.2

Z04.2 is the ICD-10-CM diagnosis code for encounter for examination and observation following work accident. It belongs to category Z04 (encounter for examination and observation for other reasons), block Z00-Z13 (persons encountering health services for examinations) and chapter 21 (factors influencing health status and contact with health services). It is billable, so it can be reported on its own for dates of service from October 1, 2026 through September 30, 2027.

Within Z04 (encounter for examination and observation for other reasons), Z04.2 is specifically for encounter for examination and observation following work accident. Related codes cover examination and observation following transport accident (Z04.1), examination and observation following other accident (Z04.3), examination and observation following alleged rape (Z04.4), general psychiatric examination, requested by authority (Z04.6), examination and observation following alleged physical abuse (Z04.7), examination and observation for other specified reasons (Z04.8) and examination and observation for unspecified reason (Z04.9).

It is not a CC or MCC, so as a secondary diagnosis it doesn't change the MS-DRG severity level.

In MS-DRG v44.0, it is part of the grouping logic for DRG 922 (Other Injury, Poisoning and Toxic Effect Diagnoses with MCC, relative weight 1.6238) and DRG 923 (Other Injury, Poisoning and Toxic Effect Diagnoses without MCC, relative weight 0.9973), in MDC 21 (Injuries, Poisonings and Toxic Effects of Drugs), as a principal or secondary diagnosis. The DRG a claim lands in depends on the principal diagnosis, procedures and any CC/MCC secondary diagnoses.

It has been part of ICD-10-CM since the code set took effect on October 1, 2015 and hasn't changed since.

Before ICD-10, this condition was coded in ICD-9-CM as V71.3 (observation following accident at work).

Notes that apply from higher levels

Instructions written at a parent level also apply to Z04.2.

› From Z04 Encounter for examination and observation for other reasons
Includes
  • encounter for examination for medicolegal reasons
  • This category is to be used when a person without a diagnosis is suspected of having an abnormal condition, without signs or symptoms, which requires study, but after examination and observation, is ruled-out. This category is also for use for administrative and legal observation status.

Broader instructions also apply from Z00-Z13 Persons encountering health services for examinations and Chapter 21: Factors influencing health status and contact with health services.

Alphabetic index entries

4 entries

Terms in the official ICD-10-CM index that lead to Z04.2.

Codes whose notes reference Z04.2

MS-DRG v44.0 grouping

All DRGs →

Inpatient MS-DRGs this diagnosis can group to, as the principal or a secondary diagnosis, depending on the rest of the claim.

ICD-9-CM equivalent

Converter →
  • V71.3Observation following accident at workexact

From the CMS 2018 General Equivalence Mappings (GEMs), the final GEMs release.

Code history

  1. 2016
  2. 2017
  3. 2018
  4. 2019
  5. 2020
  6. 2021
  7. 2022
  8. 2023
  9. 2024
  10. 2025
  11. 2026
  12. 2027
  • FY2016 (effective 10/1/2015): Added (first year of ICD-10-CM)
  • No changes since FY2016.

Common questions about Z04.2

Is Z04.2 billable?

Yes. Z04.2 is a billable/specific ICD-10-CM code valid for FY2027 (October 1, 2026 – September 30, 2027).

Can Z04.2 be used as a principal diagnosis?

Yes. The Medicare Code Editor doesn't restrict Z04.2 as a principal diagnosis.

Is Z04.2 a CC or MCC?

No. Z04.2 is neither a CC nor an MCC under MS-DRG v44.0.

What DRG does Z04.2 group to?

Z04.2 is used in the MS-DRG v44.0 logic for MS-DRG 922 (Other Injury, Poisoning and Toxic Effect Diagnoses with MCC) and MS-DRG 923 (Other Injury, Poisoning and Toxic Effect Diagnoses without MCC). Which one applies depends on whether it is the principal diagnosis and on the rest of the claim.

What is the ICD-9 code for Z04.2?

The CMS General Equivalence Mappings map Z04.2 to ICD-9-CM V71.3.