CPT (Current Procedural Terminology) codes are five-digit numeric codes used to describe medical, surgical, and diagnostic services. They are maintained by the American Medical Association and used by healthcare providers, insurers, and Medicare for billing and reimbursement.

What is the difference between facility and non-facility rates?

Non-facility (office) rates are what Medicare pays when a service is performed in a physician's office. Facility rates are lower because when a service is performed in a hospital or ambulatory surgery center, the facility bills separately for overhead costs like equipment and supplies.

RVU stands for Relative Value Unit. Medicare uses RVUs to measure the value of physician services based on three components: physician work, practice expense, and malpractice cost. Total RVUs are multiplied by the conversion factor ($33.40 in 2026) to calculate the Medicare payment amount.

Is Z11.52 a billable ICD-10-CM code?

Yes. Z11.52 (Encounter for screening for COVID-19) is a billable/specific ICD-10-CM code and can be reported on a claim when the documentation supports it.

ICD-10-CM · Z00–Z99Billable

ICD-10-CM Code Z11.52

Encounter for screening for COVID-19

Source: CMS ICD-10-CM FY2026Effective October 1, 2025Reviewed by the D3rx Clinical Billing Team

Diagnosis information

Billable

Yes

Valid for claim submission

Chapter

Z00–Z99

Factors influencing health status and contact with health services

Risk adjustment

None

Not risk-adjustable (V28)

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More codes in the Z11 category

Other billable ICD-10-CM codes in the same category as Z11.52. Coding to the highest specificity the documentation supports is what keeps a claim clean — pick the child code that most precisely matches the diagnosis.

Z11.0Encounter for screening for intestinal infectious diseases
Z11.1Encounter for screening for respiratory tuberculosis
Z11.2Encounter for screening for other bacterial diseases
Z11.3Encounter for screening for infections with a predominantly sexual mode of transmission
Z11.4Encounter for screening for human immunodeficiency virus [HIV]
Z11.51Encounter for screening for human papillomavirus (HPV)
Z11.59Encounter for screening for other viral diseases
Z11.6Encounter for screening for other protozoal diseases and helminthiases
Z11.7Encounter for testing for latent tuberculosis infection
Z11.8Encounter for screening for other infectious and parasitic diseases
Z11.9Encounter for screening for infectious and parasitic diseases, unspecified

Documentation & coding notes

Z11.52 is a billable/specific ICD-10-CM code — it can be reported as a primary or secondary diagnosis when the documentation supports it. Code to the highest level of specificity the record allows.
As a Z-code (factor influencing health status), Z11.52 is often a secondary code that explains the reason for an encounter or a relevant status. Sequencing depends on why the patient presented; some payers restrict Z-codes as a first-listed diagnosis.
Always verify the code against the current ICD-10-CM Official Guidelines and the payer's coverage policy before submitting — coverage, medical necessity edits, and sequencing rules vary by payer.

Related Z00–Z99 codes

Z23 Z00.00 Z12.11 Z79.4 Z00.01 Z11.51 Z79.899 Z51.11

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Medical coding disclaimer

ICD-10-CM codes and descriptions shown are from the CMS FY2026 official code set and HCC mappings from the CMS-HCC V28 model (payment year 2026), shown for educational reference. Official Guidelines, payer coverage, medical-necessity edits, and sequencing rules vary. Always verify with the current ICD-10-CM Official Guidelines and the payer before submitting claims. D3rx is not responsible for coding or billing outcomes.