ICD-10 · PDGM grouping
Z04 Encounter for examination and observation for other reasons
All 12 codes in the Z04 family, with the PDGM clinical group, comorbidity subgroup and primary-position rule CMS assigns, read from the CMS grouper crosswalk v07.2.26 and the CDC FY2027 code file.
Codes in family
12
Can lead a claim
0
Cannot lead a claim
12
What CMS assigns to Z04
None of the 12 codes is assigned a clinical group. None of the 12 is assigned a comorbidity subgroup. None can lead a claim.
Every code in Z04
Descriptions are CDC’s FY2027 wording; where CMS’s grouper abbreviates one, its form is shown beneath.
| Code | Description | Primary position | Clinical group | Comorbidity subgroup |
|---|---|---|---|---|
| Z04.1 | Encounter for examination and observation following transport accidentCMS: Encounter for exam and obs following transport accident | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| Z04.2 | Encounter for examination and observation following work accidentCMS: Encounter for exam and observation following work accident | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| Z04.3 | Encounter for examination and observation following other accidentCMS: Encounter for exam and observation following oth accident | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| Z04.4 Encounter for examination and observation following alleged rape | ||||
| Z04.41 | Encounter for examination and observation following alleged adult rapeCMS: Encounter for exam and obs following alleged adult rape | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| Z04.42 | Encounter for examination and observation following alleged child rapeCMS: Encounter for exam and obs following alleged child rape | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| Z04.6 | Encounter for general psychiatric examination, requested by authorityCMS: Encntr for general psychiatric exam, requested by authority | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| Z04.7 Encounter for examination and observation following alleged physical abuse | ||||
| Z04.71 | Encounter for examination and observation following alleged adult physical abuseCMS: Encntr for exam and obs fol alleged adult physical abuse | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| Z04.72 | Encounter for examination and observation following alleged child physical abuseCMS: Encntr for exam and obs fol alleged child physical abuse | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| Z04.8 Encounter for examination and observation for other specified reasons | ||||
| Z04.81 | Encounter for examination and observation of victim following forced sexual exploitationCMS: Enctr for exam and obs of victim fol forced sex exploitation | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| Z04.82 | Encounter for examination and observation of victim following forced labor exploitationCMS: Enctr for exam and obs of vctm fol forced labor exploitation | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| Z04.89 | Encounter for examination and observation for other specified reasonsCMS: Encounter for examination and observation for oth reasons | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| Z04.9 | Encounter for examination and observation for unspecified reasonCMS: Encounter for examination and observation for unsp reason | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
Sources: CMS HH PPS Grouper Software v07.2.26, effective 2026-10-01, for the clinical group, comorbidity subgroup, code-first conventions and primary-position flags; CDC NCHS ICD-10-CM FY2027 code descriptions for the family title and code wording. This is the crosswalk Medicare runs a claim through. Grouping also depends on admission source, timing, the OASIS functional items and the rest of the diagnosis list.
The monthly home health regs digest
What CMS changed, what's due next, and what to do about it — one email a month, no fluff. Read the first issue