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ICD-10-CM Z01.411: Encounter for gynecological examination (general) (routine) with abnormal findings

Z01.411 is the billable ICD-10-CM code for encounter for gynecological examination (general) (routine) with abnormal findings, in category Z01 (Encounter for other special examination without complaint, suspected or reported diagnosis) of the Persons encountering health services for examinations section. As a principal diagnosis it groups to MS-DRG 951 Other Factors Influencing Health Status (MDC 23 MDC 23: Factors Influencing Health Status and Other Contacts with Health Services).

Compiled from CMS files by the QuickIntell RCM Editorial Team · Data effective · Method: reference methodology · Report a data correction

Data currency: ICD-10-CM code descriptions: FY2027 (effective October 1, 2026); IPPS Table 5 (MS-DRG weights): v44 FY2027 (final rule + CN3) (effective October 1, 2026); ICD-10-CM to HCC mapping: PY2027 initial ICD-10-CM mappings (dates of service 2026) (payment year 2027); Medicare Coverage Database billing and coding articles: MCD release October 8, 2026 (effective October 4, 2026). Next CMS release: FY2028 code files, effective October 1, 2027 for the ICD-10-CM code descriptions; FY2028 final rule (August 2027), effective October 1, 2027; an April 1 interim grouper update when CMS issues one for the IPPS Table 5 (MS-DRG weights); PY2028 advance notice (February 2027) and the PY2027 midyear final mapping (spring 2027) for the ICD-10-CM to HCC mapping; weekly, every Thursday for the Medicare Coverage Database billing and coding articles.

Code
Z01.411
billable FY2027 ICD-10-CM code
Category
Z01 Encounter for other special examination without complaint, suspected or reported diagnosis
Chapter
21: Factors influencing health status and contact with health services (Z00-Z99)
CC/MCC (MS-DRG v44)
Neither
CMS-HCC V28
Not mapped
POA reporting
Exempt

Tabular list notes for Z01.411

The tabular list has no notes on Z01.411 itself; the notes below apply from its parent headings.

Inherited from Z01 (Encounter for other special examination without complaint, suspected or reported diagnosis)

Includes
  • routine examination of specific system
Excludes1 (never coded together)
  • encounter for examination for administrative purposes (Z02.-)
  • encounter for examination for suspected conditions, proven not to exist (Z03.-)
  • encounter for laboratory, radiologic and imaging examinations for sign(s) and symptom(s) - code to the sign(s) or symptom(s)
Excludes2 (not part of this condition, may be coded together)
  • encounter for laboratory and radiologic examinations as a component of general medical examinations (Z00.0-)
  • screening examinations (Z11-Z13)
Notes
  • Codes from category Z01 represent the reason for the encounter. A separate procedure code is required to identify any examinations or procedures performed

Inherited from Z01.4 (Encounter for gynecological examination)

Excludes2 (not part of this condition, may be coded together)
  • pregnancy examination or test (Z32.0-)
  • routine examination for contraceptive maintenance (Z30.4-)

Inherited from Z01.41 (Encounter for routine gynecological examination)

Inclusion terms
  • Encounter for general gynecological examination with or without cervical smear
  • Encounter for gynecological examination (general) (routine) NOS
  • Encounter for pelvic examination (annual) (periodic)
Excludes1 (never coded together)
  • gynecologic examination status-post hysterectomy for malignant condition (Z08)
  • screening cervical pap smear not a part of a routine gynecological examination (Z12.4)
Use additional code
  • code:
  • for screening for human papillomavirus, if applicable, (Z11.51)
  • for screening vaginal pap smear, if applicable (Z12.72)
  • to identify acquired absence of uterus, if applicable (Z90.71-)

MS-DRG grouping when Z01.411 is the principal diagnosis

MS-DRG v44 groups for Z01.411 as principal diagnosis
MDCMS-DRGs
23 MDC 23: Factors Influencing Health Status and Other Contacts with Health Services951

The final group also depends on procedures, secondary diagnoses and discharge status; the MS-DRG lookup for Z01.411 shows the full grouping logic.

CC/MCC status and inpatient edits

Z01.411 is neither a CC nor an MCC under MS-DRG v44, so as a secondary diagnosis it does not raise the MS-DRG severity level. Check Z01.411 against a principal diagnosis.

  • Present on admission: exempt from POA indicator reporting (FY2027 exempt list).

CMS-HCC V28 risk adjustment

Z01.411 does not map to a payment HCC in the PY2027 CMS-HCC V28 model, so on its own it does not change a Medicare Advantage risk score.

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Frequently asked questions

What does ICD-10-CM Z01.411 mean?

Z01.411 means encounter for gynecological examination (general) (routine) with abnormal findings. It is one of 23 billable codes under Z01, encounter for other special examination without complaint, suspected or reported diagnosis.

What can't be coded with Z01.411?

Excludes1 at Z01.41: gynecologic examination status-post hysterectomy for malignant condition (Z08); screening cervical pap smear not a part of a routine gynecological examination (Z12.4). These are never reported together with Z01.411.

Which MS-DRG does Z01.411 group to?

As the principal diagnosis, Z01.411 groups to MS-DRG 951 Other Factors Influencing Health Status (MDC 23 MDC 23: Factors Influencing Health Status and Other Contacts with Health Services) under MS-DRG v44, before procedures and secondary diagnoses are applied.

Sources

Every figure on this page is taken from the CMS publications below, as released by the Centers for Medicare & Medicaid Services. Projection built 2026-10-10. Verify against the primary file before billing or contracting decisions. The reference methodology explains how each figure is computed from these files.

Disclaimer

The descriptor and notes are reproduced from the FY2027 ICD-10-CM files; MS-DRG, CC/MCC and HCC facts come from the CMS FY2027 and PY2027 tables. Code from the medical record and the ICD-10-CM Official Guidelines. Not legal, clinical or billing advice.

Found a figure that does not match the CMS file? Report a data correction with the CMS file and the value you expected; the request reaches the editorial team through the contact form.