ICD-10 Z29.81
Billable / SpecificEncounter for HIV pre-exposure prophylaxis
About ICD-10-CM Z29.81
ICD-10-CM code Z29.81 represents Encounter for HIV pre-exposure prophylaxis. This is a billable/specific code in the Factors Influencing Health Status chapter (block Z29). The 2026 edition of ICD-10-CM Z29.81 became effective on October 1, 2025.
Coding Notes
Code Also
- , if applicable, risk factors for HIV, such as:
- contact with and (suspected) exposure to human immunodeficiency virus [HIV] (Z20.6)
- high risk sexual behavior (Z72.5-)
Medicare LCD Coverage for Z29.81
Local Coverage Determinations (LCDs) from CMS MACs that list Z29.81 as a covered diagnosis.
This doesn't mean the code isn't covered, it means no MAC has issued a Local Coverage Determination naming this specific code. Coverage may still apply under National Coverage Determinations or general medical-necessity rules.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing Z29.81.
1 Cigna
CPT Codes Commonly Billed with Z29.81
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
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.
Codes Adjacent To Z29.81
Other codes in section Z20-Z29 (Persons with potential health hazards related to communicable diseases).
ICD-10 Z29.81, Billing FAQ
Is ICD-10 code Z29.81 billable? +
Yes, Z29.81 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
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