Z29.81 Encounter for HIV pre-exposure prophylaxis

The ICD-10-CM code for Encounter for HIV pre-exposure prophylaxis is Z29.81 (FY2026). It is a billable, claim-ready diagnosis code.

Classification

Chapter

21: Factors influencing health status and contact with health services (Z00-Z99)

Section

Z20-Z29: Persons with potential health hazards related to communicable diseases (Z20-Z29)

Category Z29

11 codes (8 billable)

FY2026 Status

Stable since FY2024

Also Known As

ICD-10-CM Alphabetic Index entries that lead to Z29.81:

• Encounter (with health service) (for) › prophylactic measures › HIV pre-exposure
• Encounter (with health service) (for) › HIV › PrEP
• Encounter (with health service) (for) › HIV › pre-exposure prophylaxis

U.S. Hospital Utilization

Z29.81 appeared in too few sampled U.S. inpatient stays in 2023 to report a national estimate (AHRQ suppresses counts of 10 or fewer) — a rare inpatient diagnosis.

Source: National Inpatient Sample (NIS), Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality, 2016–2023. National survey-weighted estimates.

Official Coding Guidelines

Encounter for HIV pre-exposure prophylaxis (PrEP)

(k) Encounter for HIV Prophylaxis Measures When a patient presents for administration of pre-exposure prophylaxis medication for HIV, assign code Z29.81, Encounter for HIV pre-exposure prophylaxis. Pre-exposure prophylaxis (PrEP) is intended to prevent infection in people who are at risk for getting HIV through sex or injection drug use. Any risk factors for HIV should also be coded.

Used with any code in range A00.0-T88.9, Z00-Z99

1) Used with any code in the range of A00.0-T88.9, Z00-Z99 An external cause code may be used with any code in the range of A00.0-T88.9, Z00-Z99, classification that represents a health condition due to an external cause. Though they are most applicable to injuries, they are also valid for use with such things as infections or diseases due to an external source, and other health conditions, such as a heart attack that occurs during strenuous physical activity.

Source: CMS — ICD-10-CM Official Guidelines for Coding and Reporting, FY2026

References

• CMS — ICD-10-CM Official Code Set and Guidelines, FY2026
• CDC/NCHS — ICD-10-CM Files and Browser Tool
• AHRQ — HCUP National Inpatient Sample, Frequencies by Diagnosis Code (2016–2023)