Z11.4 ICD-10-CM Code: Encounter for screening for human immunodeficiency virus [HIV]

Z11.4 is the ICD-10-CM diagnosis code for encounter for screening for human immunodeficiency virus [hiv]. A visit to get tested for HIV (human immunodeficiency virus) infection, typically as part of preventive health screening or risk assessment. Z11.4 sits in the ICD-10-CM chapter for factors influencing health status and contact with health services (z00-z99), within the section covering persons encountering health services for examinations (z00-z13).

Z11.4 is a billable ICD-10-CM code but does not map to a payment HCC under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can be reported on Medicare Advantage encounter data submissions but it does not contribute to a beneficiary's RAF score and therefore does not affect risk-adjusted payments to the plan.

Use this code for screening encounters only; if HIV is diagnosed, use B20 or B21 codes instead.