Z16 — Resistance to antimicrobial drugs
Z16 is a non-billable header ICD-10-CM code for resistance to antimicrobial drugs. It cannot be billed on its own: choose one of the more specific child codes below.
Excludes1 — never code together
These conditions cannot occur together. Billing both on the same encounter is a denial.
Code first
The underlying condition must be sequenced before this code.
- the infection
Notes
Additional guidance from the ICD-10-CM tabular list.
- The codes in this category are provided for use as additional codes to identify the resistance and non-responsiveness of a condition to antimicrobial drugs.
Other codes that can never be billed with Z16
These codes carry an Excludes1 note pointing at Z16. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading Z16 alone.
Risk adjustment
Z16 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.
Code to one of these instead Z16
3 child codes. Green means billable.
Questions about Z16
- Is Z16 a billable ICD-10-CM code?
- No. Z16 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
- Where does Z16 sit in the tabular list?
- Factors influencing health status and contact with health services (Z00-Z99), in the block Resistance to antimicrobial drugs (Z16).
- What cannot be coded together with Z16?
- Z16 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.