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

ICD-10 Z21

Billable / Specific HCC v28: 1

Asymptomatic human immunodeficiency virus [HIV] infection status

Z21
Block
1
Synonyms
707
LCDs
14
Payer Policies
0
Linked CPTs

About ICD-10-CM Z21

ICD-10-CM code Z21 represents Asymptomatic human immunodeficiency virus [HIV] infection status. This is a billable/specific code in the Factors Influencing Health Status chapter (block Z21). The 2026 edition of ICD-10-CM Z21 became effective on October 1, 2025.

Coding Tips for Z21

Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.

HCC capture: document with MEAT each year

Z21 is a CMS-HCC v28 risk-adjustment code (category 1). To count for the patient Risk Adjustment Factor (RAF), document the diagnosis with MEAT language each calendar year: Monitored, Evaluated, Assessed, Treated. A diagnosis on the problem list alone does not satisfy CMS RADV audit standards. Include the diagnosis in the assessment with current status and current treatment plan.

Inclusion Terms / Approximate Synonyms

Clinical terms and conditions classified under Z21. Per CMS ICD-10-CM Tabular 2026.

  • HIV positive NOS

Type 1 Excludes

Pure excludes, these codes can never be coded together with Z21. The conditions are mutually exclusive (e.g., congenital vs acquired forms).

  • acquired immunodeficiency syndrome (B20)
  • contact with human immunodeficiency virus [HIV] (Z20.6)
  • exposure to human immunodeficiency virus [HIV] (Z20.6)
  • human immunodeficiency virus [HIV] disease (B20)
  • inconclusive laboratory evidence of human immunodeficiency virus [HIV] (R75)

Coding Notes

Code First

  • Human immunodeficiency virus [HIV] disease complicating pregnancy, childbirth and the puerperium, if applicable (O98.7-)

Medicare Advantage HCC Impact

CMS-HCC v28 (current)
Category 1
ESRD-HCC
Category 1
RxHCC (Part D)
Category 1

Capture this diagnosis annually for accurate risk adjustment. Missed HCC captures are the #1 revenue leak in Medicare Advantage risk programs.

Medicare LCD Coverage for Z21

Local Coverage Determinations (LCDs) from CMS MACs that list Z21 as a covered diagnosis.

707 LCDs

Showing top 10 of 707 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Pharmacogenomics Testing
Article ID: 58801, Effective: 2026-01-01 00:00:00, 578 covered, 0 non-covered
CPT 81227 →
CMS LCD: Billing and Coding: Pharmacogenomics Testing
Article ID: 58801, Effective: 2026-01-01 00:00:00, 578 covered, 0 non-covered
CPT 81328 →
CMS LCD: Billing and Coding: Pharmacogenomics Testing
Article ID: 58801, Effective: 2026-01-01 00:00:00, 578 covered, 0 non-covered
CPT 81335 →
CMS LCD: Billing and Coding: Pharmacogenomics Testing
Article ID: 58801, Effective: 2026-01-01 00:00:00, 578 covered, 0 non-covered
CPT 0071U →
CMS LCD: Billing and Coding: Pharmacogenomics Testing
Article ID: 58801, Effective: 2026-01-01 00:00:00, 578 covered, 0 non-covered
CPT 81383 →
CMS LCD: Billing and Coding: Pharmacogenomics Testing
Article ID: 58801, Effective: 2026-01-01 00:00:00, 578 covered, 0 non-covered
CPT 81418 →
CMS LCD: Billing and Coding: Pharmacogenomics Testing
Article ID: 58801, Effective: 2026-01-01 00:00:00, 578 covered, 0 non-covered
CPT 0073U →
CMS LCD: Billing and Coding: Pharmacogenomics Testing
Article ID: 58801, Effective: 2026-01-01 00:00:00, 578 covered, 0 non-covered
CPT 81283 →
CMS LCD: Billing and Coding: Pharmacogenomics Testing
Article ID: 58801, Effective: 2026-01-01 00:00:00, 578 covered, 0 non-covered
CPT 81408 →
CMS LCD: Billing and Coding: Pharmacogenomics Testing
Article ID: 58801, Effective: 2026-01-01 00:00:00, 578 covered, 0 non-covered
CPT 81355 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing Z21.

14 policies

1 Aetna

Hepatitis A Vaccine - Medical Clinical Policy Bulletins | Aetna
Policy ID: CPB-0048

3 Cigna

Flow Cytometry - (0538)
Policy ID: MM_0538
Nucleic Acid Pathogen Testing - (0530)
Policy ID: MM_0530
Transthoracic Echocardiography in Children - (0523)
Policy ID: MM_0523

5 Medicare

Billing and Coding: Lab: Flow Cytometry
Policy ID: ART-55717
Billing and Coding: Flow Cytometry
Policy ID: ART-56464
Billing and Coding: Lab: Flow Cytometry
Policy ID: ART-57689
Billing and Coding: MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing
Policy ID: ART-58710
Billing and Coding: MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing
Policy ID: ART-58720

CPT Codes Commonly Billed with Z21

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

No procedure linkages on file for Z21

We don't have CPT pairings indexed for this specific code yet. Use the CPT search above to find common procedures, or check your payer's published medical policy for code-specific guidance.

Convert Z21 to ICD-9-CM

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

ICD-10ICD-9Mapping Flags
Z21 V08 00000

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

Codes Adjacent To Z21

Other codes in section Z20-Z29 (Persons with potential health hazards related to communicable diseases).

Z20 Contact with and (suspected) exposure to communicable diseases (non-billable) Z20.0 Contact with and (suspected) exposure to intestinal infectious diseases (non-billable) Z20.01 Contact with and (suspected) exposure to intestinal infectious diseases due to Escherichia coli (E. coli) Z20.09 Contact with and (suspected) exposure to other intestinal infectious diseases Z20.1 Contact with and (suspected) exposure to tuberculosis Z20.2 Contact with and (suspected) exposure to infections with a predominantly sexual mode of transmission Z20.3 Contact with and (suspected) exposure to rabies Z20.4 Contact with and (suspected) exposure to rubella Z20.5 Contact with and (suspected) exposure to viral hepatitis Z20.6 Contact with and (suspected) exposure to human immunodeficiency virus [HIV] Z20.7 Contact with and (suspected) exposure to pediculosis, acariasis and other infestations Z20.8 Contact with and (suspected) exposure to other communicable diseases (non-billable) Z20.81 Contact with and (suspected) exposure to other bacterial communicable diseases (non-billable) Z20.810 Contact with and (suspected) exposure to anthrax Z20.811 Contact with and (suspected) exposure to meningococcus Z20.818 Contact with and (suspected) exposure to other bacterial communicable diseases Z20.82 Contact with and (suspected) exposure to other viral communicable diseases (non-billable) Z20.820 Contact with and (suspected) exposure to varicella Z20.821 Contact with and (suspected) exposure to Zika virus Z20.822 Contact with and (suspected) exposure to COVID-19

ICD-10 Z21, Billing FAQ

Is ICD-10 code Z21 billable? +

Yes, Z21 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

What other names or terms map to Z21? +

ICD-10 Z21 includes: HIV positive NOS.

What codes are Type 1 Excludes for Z21? +

Type 1 Excludes (never code together with Z21): acquired immunodeficiency syndrome (B20); contact with human immunodeficiency virus [HIV] (Z20.6); exposure to human immunodeficiency virus [HIV] (Z20.6)

Does Z21 affect Medicare Advantage HCC risk adjustment? +

Yes. Z21 maps to CMS-HCC v28 category 1. Capture this diagnosis annually for accurate Medicare Advantage risk score.

What ICD-9 codes does Z21 map to? +

Per CMS GEMs, Z21 maps to ICD-9 codes: V08. Useful for legacy data review and historical claim analysis.

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Reviewed by the PayerReady Medical Coding Team

Verified against the CMS 2026 code set on June 1, 2026.

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