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Z16.2 ICD-10-CM Code: Resistance to other antibiotics

Z16.2 is not a CMS-HCC payment code. MEAT criteria · RAF calculator · HCC coding software

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FY 2026 Apr update / Factors influencing health status and contact with health services (Z00-Z99) / Resistance to antimicrobial drugs (Z16)

Z16.2

Header CodeICD-10-CMOfficial ICD-10-CMCodebook guidance

Resistance to other antibiotics

Resistance to other antibiotics

CMS-HCC V28

N/A

Not mapped

CMS-HCC V24

N/A

Not mapped

ACA/HHS

N/A

Not mapped

ESRD/PACE

N/A

Not mapped

RXHCC

N/A

Not mapped

Code Book Path

Official
Z16Resistance to antimicrobial drugs
Z16.2Resistance to other antibiotics

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for Z16.2 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for Z16.2 in this effective period.

Related Child Codes

Official
Z16.20Resistance to unspecified antibiotic
Z16.21Resistance to vancomycin
Z16.22Resistance to vancomycin related antibiotics
Z16.23Resistance to quinolones and fluoroquinolones
Z16.24Resistance to multiple antibiotics

Includes

Official

ICD-10-CM does not list Includes notes for Z16.2 in this effective period.

Excludes 1

Official
  • Methicillin resistant Staphylococcus aureus infection (A49.02)
  • Methicillin resistant Staphylococcus aureus pneumonia (J15.212)
  • Sepsis due to Methicillin resistant Staphylococcus aureus (A41.02)

Code First

Official
  • the infection

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for Z16.2 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for Z16.2 in this effective period.

Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →

Code
Z16.2
Description
Resistance to other antibiotics
HCC (V28)
No CMS-HCC V28 mapping
RAF
Billable
No
Payment year
2026

Coder workflow notes

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What This Code Means

Z16.2 is the ICD-10-CM diagnosis code for resistance to other antibiotics. Z16.2 sits in the ICD-10-CM chapter for factors influencing health status and contact with health services (z00-z99), within the section covering resistance to antimicrobial drugs (z16).

Header codes like Z16.2 cannot be reported on claims directly, they organize child codes that share clinical context but the actual diagnosis must be coded to the highest level of specificity supported by the documentation. Coders should look at Z16.2's child codes and select the one that matches the patient's documented presentation, since payers reject header codes submitted as the primary diagnosis. For risk adjustment workflows, header codes never contribute to a Medicare Advantage member's RAF score on their own; only billable child codes that happen to map to a payment HCC affect risk-adjusted plan payments.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for Z16.2 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Child Codes

Code Hierarchy

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