Z36.4
BillableEncounter for antenatal screening for fetal growth retardation
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is Z36.4 an HCC code?
No. Z36.4 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).
What This Code Means
Z36.4 is the ICD-10-CM diagnosis code for encounter for antenatal screening for fetal growth retardation. A prenatal screening test to assess whether the baby is growing at an appropriate rate for gestational age. Z36.4 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 in circumstances related to reproduction (z30-z39).
Z36.4 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.
Typically involves ultrasound measurement of fetal biometric parameters.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for Z36.4 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Typically involves ultrasound measurement of fetal biometric parameters
- •Document estimated fetal weight percentile if available