Health care providers can use International Classification of Diseases, Clinical Modification (ICD-CM) codes to distinguish between initial testing for latent tuberculosis (TB) infection and evaluation/screening for TB disease in medical records.
International Classification of Diseases
The International Classification of Diseases (ICD) is designed to promote international comparability in the collection, processing, classification, and presentation of mortality statistics. The World Health Organization (WHO) owns and publishes the classification.
In addition to the main ICD, WHO authorizes the U.S. government to develop a modification for classifying morbidity from inpatient and outpatient records, physician offices, and most National Center for Health Statistics (NCHS) surveys. This modification is known as the International Classification of Diseases, Clinical Modification (ICD-CM).
ICD-CM codes improve data collection.
As CDC and health departments work with primary care providers to expand targeted testing and treatment for latent TB infection, it is important to better distinguish between initial testing for latent TB infection and evaluation/screening for TB disease in medical records.
From 2017-2018, CDC worked with state and local TB programs and NCHS to develop new and modify existing ICD-CM codes, which will allow healthcare providers to improve clinical documentation related to latent TB infection and TB disease.
ICD-CM codes are not primarily used for public health surveillance purposes. However, they provide a way to measure uptake of healthcare recommendations and guidelines, such as the U.S. Preventive Services Task Force's recommendation to screen for latent TB infection in populations at increased risk.
The codes improve the ability to collect and use data for evidence-based decision-making at both the patient and population levels, as well as monitor latent TB infection testing trends outside of health department settings.
ICD-10-CM codes for TB
The 2020 release of ICD-10-CM included the following new and/or modified codes related to TB.
Please note that Clinical Modifications may not reflect changes to WHO's codes, for example, to modify wording.
New ICD-10-CM codes:
- Z11.7: "Encounter for testing for latent tuberculosis infection"
- Z86.15: "Personal history of latent tuberculosis infection"
- Z22.7: "Carrier of latent tuberculosis," which includes a previous positive test for TB infection without evidence of disease, but excludes:
- "Nonspecific reaction to cell-mediated immunity measurement of gamma interferon antigen response without active tuberculosis" (R76.12), and
- "Nonspecific reaction to tuberculin skin test without active tuberculosis" (R76.11).
- "Nonspecific reaction to cell-mediated immunity measurement of gamma interferon antigen response without active tuberculosis" (R76.12), and
Modified ICD-10-CM code:
Z11.1: "Encounter for screening for respiratory tuberculosis" now includes "Encounter for screening for active tuberculosis disease."