Attention: Providers of Well Child Exams - Clarification of Appropriate Diagnosis Codes

Effective July 1, 2021, providers must use the most appropriate diagnosis code as the primary diagnosis for the well child exam.

Effective for dates of service on or after July 1, 2021, providers must use the most appropriate diagnosis code from the below table as the primary diagnosis for the well child exam. 

Please note: The Health Check Program Guide will be updated by July 1, 2021, to include codes Z00.00 and Z00.01.

ICD-10 Diagnosis Code

Code Description

Z00.110

Health examination for newborn under 8 days old

Z00.111

Health examination for newborn 8 to 28 days old

Z00.121

Encounter for routine child health examination with abnormal findings

Z00.129

Encounter for routine child health examination without abnormal findings

Z00.00

Encounter for general adult medical exam (pt > 18 years) without abnormal findings

Z00.01

Encounter for general adult medical exam (pt > 18 years) with abnormal find

 

The Health Check Program Guide can be found at https://medicaid.ncdhhs.gov/providers/programs-and-services/medical/wellness-visits-and-diagnostic-and-treatment-services.  

Contact

NCTracks Call Center: 800-688-6696

 

 

 

 

 

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