Z70.1 ICD-10-CM Code: Counseling related to patient's sexual behavior and orientation
HCC Buddy Code Card
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FY 2026 Apr update / Factors influencing health status and contact with health services (Z00-Z99) / Persons encountering health services in other circumstances (Z69-Z76)
Z70.1
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceCounseling related to patient's sexual behavior and orientation
A counseling visit focused on the patient's sexual behavior, sexual practices, or sexual orientation and identity.
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
Inclusion Terms
Official- Patient concerned regarding impotence
- Patient concerned regarding non-responsiveness
- Patient concerned regarding promiscuity
- Patient concerned regarding sexual orientation
Excludes 2
Official- contraceptive or procreative counseling (Z30-Z31)
Related Child Codes
Includes
Official- encounter for mental health services for sexual attitude, behavior and orientation
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for Z70.1 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for Z70.1 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for Z70.1 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for Z70.1 in this effective period.
Buddy Documentation Tip
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 →
Is Z70.1 an HCC code?
No. Z70.1 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
- Code
- Z70.1
- Description
- Counseling related to patient's sexual behavior and orientation
- HCC (V28)
- No CMS-HCC V28 mapping
- RAF
- —
- Billable
- Yes
- Payment year
- 2026
Coder workflow notes
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This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).
What This Code Means
Z70.1 is the ICD-10-CM diagnosis code for counseling related to patient's sexual behavior and orientation. A counseling visit focused on the patient's sexual behavior, sexual practices, or sexual orientation and identity. Z70.1 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 other circumstances (z69-z76).
Z70.1 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 for counseling related to sexual orientation, gender identity, or sexual behavior concerns.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for Z70.1 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Use for counseling related to sexual orientation, gender identity, or sexual behavior concerns
- •This code is patient-centered and addresses the individual's own sexual concerns