Z36.85
BillableEncounter for antenatal screening for Streptococcus B
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is Z36.85 an HCC code?
No. Z36.85 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
Z36.85 is the ICD-10-CM diagnosis code for encounter for antenatal screening for streptococcus b. A prenatal screening visit where the mother is tested for Group B Streptococcus bacteria, which can be passed to the baby during delivery. Z36.85 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).
Z36.85 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 performed at 35-37 weeks of gestation; document the specimen type and test results.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for Z36.85 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Typically performed at 35-37 weeks of gestation; document the specimen type and test results
- •If positive, use additional codes for Group B Streptococcus carrier status and ensure appropriate delivery precautions are documented