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

ICD-10 Z72.51

Billable / Specific

High risk heterosexual behavior

Z72
Block
0
Synonyms
537
LCDs
10
Payer Policies
0
Linked CPTs

About ICD-10-CM Z72.51

ICD-10-CM code Z72.51 represents High risk heterosexual behavior. This is a billable/specific code in the Factors Influencing Health Status chapter (block Z72). The 2026 edition of ICD-10-CM Z72.51 became effective on October 1, 2025.

Medicare LCD Coverage for Z72.51

Local Coverage Determinations (LCDs) from CMS MACs that list Z72.51 as a covered diagnosis.

537 LCDs

Showing top 10 of 537 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing
Article ID: 58761, Effective: 2026-03-12 00:00:00, 851 covered, 0 non-covered
CPT 87555 →
CMS LCD: Billing and Coding: MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing
Article ID: 58761, Effective: 2026-03-12 00:00:00, 851 covered, 0 non-covered
CPT 87653 →
CMS LCD: Billing and Coding: MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing
Article ID: 58761, Effective: 2026-03-12 00:00:00, 851 covered, 0 non-covered
CPT 87486 →
CMS LCD: Billing and Coding: MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing
Article ID: 58761, Effective: 2026-03-12 00:00:00, 851 covered, 0 non-covered
CPT 87626 →
CMS LCD: Billing and Coding: MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing
Article ID: 58761, Effective: 2026-03-12 00:00:00, 851 covered, 0 non-covered
CPT 0109U →
CMS LCD: Billing and Coding: MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing
Article ID: 58761, Effective: 2026-03-12 00:00:00, 851 covered, 0 non-covered
CPT 87516 →
CMS LCD: Billing and Coding: MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing
Article ID: 58761, Effective: 2026-03-12 00:00:00, 851 covered, 0 non-covered
CPT 87517 →
CMS LCD: Billing and Coding: MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing
Article ID: 58761, Effective: 2026-03-12 00:00:00, 851 covered, 0 non-covered
CPT 87528 →
CMS LCD: Billing and Coding: MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing
Article ID: 58761, Effective: 2026-03-12 00:00:00, 851 covered, 0 non-covered
CPT 87476 →
CMS LCD: Billing and Coding: MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing
Article ID: 58761, Effective: 2026-03-12 00:00:00, 851 covered, 0 non-covered
CPT 87594 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing Z72.51.

10 policies

2 Cigna

Nucleic Acid Pathogen Testing - (0530)
Policy ID: MM_0530
Preventive Care Services - (A004)
Policy ID: AD_A004

4 Medicare

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
Billing and Coding: MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing
Policy ID: ART-58747
Billing and Coding: MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing
Policy ID: ART-58761

4 Aetna

Hepatitis B Vaccine
Policy ID: CPB-0410
Cervical Cancer Screening and Diagnosis
Policy ID: CPB-0443
Diagnosis of Vaginitis
Policy ID: CPB-0643
Orthopoxvirus Vaccines
Policy ID: CPB-0644

CPT Codes Commonly Billed with Z72.51

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

No procedure linkages on file for Z72.51

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 Z72.51 to ICD-9-CM

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

ICD-10ICD-9Mapping Flags
Z72.51 V692 10000

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

Codes Adjacent To Z72.51

Other codes in section Z69-Z76 (Persons encountering health services in other circumstances).

Z69 Encounter for mental health services for victim and perpetrator of abuse (non-billable) Z69.0 Encounter for mental health services for child abuse problems (non-billable) Z69.01 Encounter for mental health services for parental child abuse (non-billable) Z69.010 Encounter for mental health services for victim of parental child abuse Z69.011 Encounter for mental health services for perpetrator of parental child abuse Z69.02 Encounter for mental health services for non-parental child abuse (non-billable) Z69.020 Encounter for mental health services for victim of non-parental child abuse Z69.021 Encounter for mental health services for perpetrator of non-parental child abuse Z69.1 Encounter for mental health services for spousal or partner abuse problems (non-billable) Z69.11 Encounter for mental health services for victim of spousal or partner abuse Z69.12 Encounter for mental health services for perpetrator of spousal or partner abuse Z69.8 Encounter for mental health services for victim or perpetrator of other abuse (non-billable) Z69.81 Encounter for mental health services for victim of other abuse Z69.82 Encounter for mental health services for perpetrator of other abuse Z70 Counseling related to sexual attitude, behavior and orientation (non-billable) Z70.0 Counseling related to sexual attitude Z70.1 Counseling related to patient's sexual behavior and orientation Z70.2 Counseling related to sexual behavior and orientation of third party Z70.3 Counseling related to combined concerns regarding sexual attitude, behavior and orientation Z70.8 Other sex counseling

ICD-10 Z72.51, Billing FAQ

Is ICD-10 code Z72.51 billable? +

Yes, Z72.51 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

What ICD-9 codes does Z72.51 map to? +

Per CMS GEMs, Z72.51 maps to ICD-9 codes: V692. 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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