ICD-10-CM 2026 · Effective October 1, 2025

ICD-10 Z03.89

Billable / Specific

Encounter for observation for other suspected diseases and conditions ruled out

Z03
Block
0
Synonyms
136
LCDs
12
Payer Policies
5
Linked CPTs

About ICD-10-CM Z03.89

ICD-10-CM code Z03.89 represents Encounter for observation for other suspected diseases and conditions ruled out. This is a billable/specific code in the Factors Influencing Health Status chapter (block Z03). The 2026 edition of ICD-10-CM Z03.89 became effective on October 1, 2025.

Medicare LCD Coverage for Z03.89

Local Coverage Determinations (LCDs) from CMS MACs that list Z03.89 as a covered diagnosis.

136 LCDs

Showing top 10 of 136 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Transrectal Ultrasound
Article ID: 57427, Effective: 2024-10-01 00:00:00, 118 covered, 0 non-covered
CPT 76872 →
CMS LCD: Billing and Coding: Transrectal Ultrasound
Article ID: 57427, Effective: 2024-10-01 00:00:00, 118 covered, 0 non-covered
CPT 76873 →
CMS LCD: Billing and Coding: Breast Imaging Mammography/Breast Echography (Sonography)/Breast MRI/Ductography
Article ID: 56448, Effective: 2025-12-04 00:00:00, 156 covered, 0 non-covered
CPT 77063 →
CMS LCD: Billing and Coding: Breast Imaging Mammography/Breast Echography (Sonography)/Breast MRI/Ductography
Article ID: 56448, Effective: 2025-12-04 00:00:00, 156 covered, 0 non-covered
CPT C8905 →
CMS LCD: Billing and Coding: Breast Imaging Mammography/Breast Echography (Sonography)/Breast MRI/Ductography
Article ID: 56448, Effective: 2025-12-04 00:00:00, 156 covered, 0 non-covered
CPT 77065 →
CMS LCD: Billing and Coding: Breast Imaging Mammography/Breast Echography (Sonography)/Breast MRI/Ductography
Article ID: 56448, Effective: 2025-12-04 00:00:00, 156 covered, 0 non-covered
CPT 76641 →
CMS LCD: Billing and Coding: Breast Imaging Mammography/Breast Echography (Sonography)/Breast MRI/Ductography
Article ID: 56448, Effective: 2025-12-04 00:00:00, 156 covered, 0 non-covered
CPT 77054 →
CMS LCD: Billing and Coding: Breast Imaging Mammography/Breast Echography (Sonography)/Breast MRI/Ductography
Article ID: 56448, Effective: 2025-12-04 00:00:00, 156 covered, 0 non-covered
CPT 77047 →
CMS LCD: Billing and Coding: Breast Imaging Mammography/Breast Echography (Sonography)/Breast MRI/Ductography
Article ID: 56448, Effective: 2025-12-04 00:00:00, 156 covered, 0 non-covered
CPT 77049 →
CMS LCD: Billing and Coding: Breast Imaging Mammography/Breast Echography (Sonography)/Breast MRI/Ductography
Article ID: 56448, Effective: 2025-12-04 00:00:00, 156 covered, 0 non-covered
CPT C8903 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing Z03.89.

12 policies

5 Medicare

Billing and Coding: Zika Virus Testing by PCR and ELISA Methods
Policy ID: ART-55326
Billing and Coding: Lab: Flow Cytometry
Policy ID: ART-55717
Billing and Coding: Breast Imaging Mammography/Breast Echography (Sonography)/Breast MRI/Ductography
Policy ID: ART-56448
Billing and Coding: Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy
Policy ID: ART-56456
Billing and Coding: Flow Cytometry
Policy ID: ART-56464

CPT Codes Commonly Billed with Z03.89

Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.

5 linkages
  • 99281 Emergency department visit for level 1 patient Emergency Medicine
  • 99282 Emergency department visit for level 2 patient Emergency Medicine
  • 99283 Emergency department visit for level 3 patient Emergency Medicine
  • 99284 Emergency department visit for level 4 patient Emergency Medicine
  • 99285 Emergency department visit for level 5 patient Emergency Medicine

Convert Z03.89 to ICD-9-CM

Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.

ICD-10ICD-9Mapping Flags
Z03.89 V7189 10000

Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).

Codes Adjacent To Z03.89

Other codes in section Z00-Z13 (Persons encountering health services for examinations).

Z00 Encounter for general examination without complaint, suspected or reported diagnosis (non-billable) Z00.0 Encounter for general adult medical examination (non-billable) Z00.00 Encounter for general adult medical examination without abnormal findings Z00.01 Encounter for general adult medical examination with abnormal findings Z00.1 Encounter for newborn, infant and child health examinations (non-billable) Z00.11 Newborn health examination (non-billable) Z00.110 Health examination for newborn under 8 days old Z00.111 Health examination for newborn 8 to 28 days old Z00.12 Encounter for routine child health examination (non-billable) Z00.121 Encounter for routine child health examination with abnormal findings Z00.129 Encounter for routine child health examination without abnormal findings Z00.2 Encounter for examination for period of rapid growth in childhood Z00.3 Encounter for examination for adolescent development state Z00.5 Encounter for examination of potential donor of organ and tissue Z00.6 Encounter for examination for normal comparison and control in clinical research program Z00.7 Encounter for examination for period of delayed growth in childhood (non-billable) Z00.70 Encounter for examination for period of delayed growth in childhood without abnormal findings Z00.71 Encounter for examination for period of delayed growth in childhood with abnormal findings Z00.8 Encounter for other general examination Z01 Encounter for other special examination without complaint, suspected or reported diagnosis (non-billable)

ICD-10 Z03.89, Billing FAQ

Is ICD-10 code Z03.89 billable? +

Yes, Z03.89 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

What CPT codes are commonly billed with Z03.89? +

Procedures frequently paired with Z03.89 include: 99281, 99282, 99283, 99284, 99285.

What ICD-9 codes does Z03.89 map to? +

Per CMS GEMs, Z03.89 maps to ICD-9 codes: V7189. Useful for legacy data review and historical claim analysis.

Get the full PayerReady toolkit

Free access to CPT/ICD-10 lookup, denial appeals, fee comparator, and claim auditing with credentialing enrollment.

Start free →

Run this code through our claim audit tool

Check NCCI bundling, MUE limits, and modifier logic before submission.

Try the auditor →

Did this page help?

Quick signal so we know what to improve.

Thanks!

If you want a code reference page that doesn't exist yet, email coding@payerready.com.

Sorry to hear that.

Tell us what's missing or wrong: coding@payerready.com. We respond within 5 business days.

Reviewed by the PayerReady Medical Coding Team

Verified against the CMS 2026 code set on May 31, 2026.

Powered by 11K CPT · 98K ICD-10 · 860K MPFS rates · 4.5M NCCI edits · 9.5M NPIs. Our data methodology · About our coding team

Faster Approvals

Ready to Cut Your Enrollment Timeline in Half?

Join providers in all 50 states who handed off credentialing to a dedicated specialist. Create your free account in minutes and start enrolling the same day.

All 50 States Covered
No Long-Term Contracts
HIPAA HIPAA Compliant Platform
Dedicated Specialist Included