Z-codes are used for the reason of the encounter instead of the V codes, they are found in Chapter 21: Factors influencing health status and contact with health services (Z00-Z99). A corresponding procedure must accompany a Z code if a procedure is performed.
Review the Official ICD-10-CM Coding & Reporting Guidelines Section 1.C.21 which includes specific information on which Z codes may be considered primary. For example, it explains that certain screening codes are considered primary when they are the main reason for the patient encounter.
a. Use of Z codes in any healthcare setting Z codes are for use in any healthcare setting. Z codes may be used as either a first-listed (principal diagnosis code in the inpatient setting) or secondary code, depending on the circumstances of the encounter. Certain Z codes may only be used as first-listed or principal diagnosis.
b. Z Codes indicate a reason for an encounter Z code are not procedure codes. A corresponding procedure code must accompany a Z code to describe any procedure performed. c. Categories of Z Codes 1) Contact/Exposure Category Z20 indicates contact with, and suspected exposure to, communicable diseases. These codes are for patients who do not show any sign or symptom of a disease but are suspected to have been exposed to it by close personal contact with an infected individual or are in an area where a disease is an epidemic. Category Z77, Other contacts with and (suspected) exposures hazardous to health, indicates contact with and suspected exposures hazardous to health.
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