When Is It Ordered
Screening
Because many infected people do not have any noticeable symptoms, a number of health organizations recommend regular chlamydia screening for certain people:
Women
All sexually active women younger than age 25 and sexually active women age 25 and older who are at increased risk should get yearly screening for chlamydia, according to the Centers for Disease Control and Prevention and the American College of Obstetricians and Gynecologists . The U.S. Preventive Services Task Force and the American Academy of Pediatrics also recommend routine screening for these women .
Examples of risk factors for chlamydia infection include:
For pregnant women, the CDC recommends screening for chlamydia during the first trimester or first prenatal visit. For women younger than age 25 or at increased risk of infection, testing is repeated in the third trimester. Pregnant women diagnosed with chlamydia should be retested about 3 months after completing treatment.
Diagnosis
Chlamydia testing may also be done when your sex partner has been diagnosed with chlamydia or when you have signs and symptoms of chlamydia.
For women, if symptoms occur, they may include:
For men, symptoms may include:
How Is Chlamydia Treated
Your healthcare practitioner will prescribe antibiotics to treat chlamydia. Antibiotics can cure your infection, but damage from the infection may sometimes be permanent. If symptoms do not resolve after a few days, consult your healthcare provider. You should refrain from having sex until you have completed your treatment and should be re-tested three months after treatment.
Infections With A Predominantly Sexual Mode Of Transmissiontype 1 Excludes
- Maternal gonorrhea complicating pregnancy, after childbirth
- Maternal gonorrhea during pregnancy
- Maternal gonorrhea during pregnancy – baby delivered
- 867 Other infectious and parasitic diseases diagnoses with mcc
- 868 Other infectious and parasitic diseases diagnoses with cc
- 869 Other infectious and parasitic diseases diagnoses without cc/mcc
- : New code
- 2017
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The Above Policy Is Based On The Following References:
Encounter For Screening For Infections With A Predominantly Sexual Mode Of Transmission

- 2016201720182019202020212022Billable/Specific CodePOA Exempt
- Z11.3 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes.
- Short description: Encntr screen for infections w sexl mode of transmiss
- The 2022 edition of ICD-10-CM Z11.3 became effective on October 1, 2021.
- This is the American ICD-10-CM version of Z11.3 – other international versions of ICD-10 Z11.3 may differ.
type 2 excludes
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Certain Infectious And Parasitic Diseasesincludes
- certain localized infections – see body system-related chapters
- carrier or suspected carrier of infectious disease
- infectious and parasitic diseases complicating pregnancy, childbirth and the puerperium
- infectious and parasitic diseases specific to the perinatal period
- influenza and other acute respiratory infections
- code to identify resistance to antimicrobial drugs
How Can Chlamydia Be Prevented
The most reliable ways to avoid infection with chlamydia or any sexually transmitted disease are to abstain from oral, vaginal, and anal sex or to be in a long-term, mutually monogamous relationship with an uninfected partner. People who are sexually active should correctly and consistently use condoms to reduce the risk of infection with chlamydia and other STDs.
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When To Get Tested
Encounter For Screening For Infectious And Parasitic Diseases Unspecified
- 2016201720182019202020212022Billable/Specific CodePOA Exempt
Z11.8 Encounter for screening for other infectious and parasitic diseases
Reimbursement claims with a date of service on or after October 1, 2015 require the use of ICD-10-CM codes.
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Screening For Stds Coverage Rules
The Affordable Care Act mandates that private health plans provide coverage for a range of preventive services and may not impose cost sharing on patients receiving these services. Services covered by private health plans vary by payer, and providers need to be knowledgeable about the covered services of their largest payers.
Private health plans may cover the following services:
- Screening for chlamydial infection for all sexually active non-pregnant young women aged 24 and younger and for older non-pregnant women who are at increased risk,
- Screening for chlamydial infection for all pregnant women aged 24 and younger and for older pregnant women who are at increased risk
- Screening for gonorrhea infection in all sexually active women, including those who are pregnant, if they are at increased risk
- Screening for syphilis infection for all pregnant women and for all persons at increased risk
- Screening for hepatitis B virus infection in pregnant women at their first prenatal visit
- HIBC for the prevention of STIs for all sexually active adolescents, and for adults at increased risk for STIs
The STD Training and Technical Assistance Centers lists the coverage rules for preventive services as follows:
In the cases where recommendations for preventive services and counseling apply only to high-risk individuals, it falls on the healthcare provider to determine whether a patient belongs to the population in consideration.
Other Diseases Caused By Chlamydiae
- 2016201720182019202020212022Non-Billable/Non-Specific Code
- Chlamydia in pregnancy
- Chlamydia trachomatis infection in childbirth
- Chlamydia trachomatis infection in pregnancy
- Chlamydial infection
- Postpartum chlamydia infection
- : New code
- 2017
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Medicare Screening For Chlamydia And Gonorrhea Syphilis And Hepatitis B
Screening for chlamydia and gonorrhea:Pregnant women who are 24 years old or younger when the diagnosis of pregnancy is known and then repeat screening during the third trimester if high-risk sexual behavior has occurred since the initial screening test Pregnant women who are at increased risk for STIs when the diagnosis of pregnancy is known and then repeat screening during the third trimester if high-risk sexual behavior has occurred since the initial screening test andWomen at increased risk for STIs annually.
Screening for syphilis:Pregnant women when the diagnosis of pregnancy is known and then repeat screening during the third trimester and at delivery if high-risk sexual behavior has occurred since the previous screening test andMen and women at increased risk for STIs annually.
Screening for hepatitis B:Pregnant women at the first prenatal visit when the diagnosis of pregnancy is known and then re-screening at the time of delivery for those with new or continuing risk factors.
How Is The Test Used

Chlamydia testing is used to screen for and diagnose sexually transmitted infections caused by the bacteria Chlamydia trachomatis.
Testing for Chlamydia trachomatis and Neisseria gonorrhoeae is often done at the same time since the infections caused by these two bacteria can have similar signs and symptoms. These bacteria may be acquired at the same time, and you may have infections with both. A definitive diagnosis is important since the two infections require different antibiotic treatment.
Repeat testing is recommended to ensure that treatment has been effective. This is done about three months after you have completed treatment.
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What Does The Test Result Mean
A positive test indicates you have an active chlamydia infection that requires treatment with antibiotics.
A negative test means only that there is no evidence of infection at the time of the test. If you are at an increased risk, it is important that you have screening tests performed yearly to check for possible infection, especially since re-infection is common, particularly among teenagers.
If you are infected, your sexual partner should be tested and treated as well.
Chlamydial Infection Of Genitourinary Tract Unspecified
- 2016201720182019202020212022Billable/Specific Code
- A56.2 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes.
- The 2022 edition of ICD-10-CM A56.2 became effective on October 1, 2021.
- This is the American ICD-10-CM version of A56.2 – other international versions of ICD-10 A56.2 may differ.
- Applicable To annotations, or
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Factors Influencing Health Status And Contact With Health Servicesnote
Encounter For Screening For Infectious And Parasitic Diseases
- 2016201720182019202020212022Non-Billable/Non-Specific Code
- encounter for diagnostic examination-code to sign or symptom
- Screening for gonorrhea
- Screening for sexually transmitted disease
- Screening for sexually transmitted disease done
- Sexually transmitted disease screening done
- Z11.3 is considered exempt from POA reporting.
- 951 Other factors influencing health status
- : New code
- 2017
Z11.3 Encounter for screening for infections with a predominantly sexual mode of transmission
Reimbursement claims with a date of service on or after October 1, 2015 require the use of ICD-10-CM codes.
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What Is Being Tested
Chlamydia is one of the most common bacterial sexually transmitted diseases in the United States and can cause serious complications if not treated. Chlamydia testing identifies the bacteria Chlamydia trachomatis as the cause of your infection.
The preferred method for chlamydia testing is the nucleic acid amplification test that detects the genetic material of Chlamydia trachomatis. It is generally more sensitive and specific than other chlamydia tests and can be performed on a vaginal swab on women or urine from both men and women, which eliminates the need for a pelvic exam in women.
Screening for, diagnosing, and treating chlamydia is very important in preventing long-term complications and spread of the infection to others. Chlamydia infections are especially common among people 15 to 24 years of age. The Centers for Disease Control and Prevention estimates that 2.86 million Americans are infected with chlamydia each year and notes that women are frequently re-infected if their partners don’t get treatment. The actual number of cases may be higher since many people do not experience any symptoms and do not get tested and diagnosed. Still, over one million new cases are reported each year.
Chlamydia is generally spread through sexual contact with an infected partner. Risk factors include having multiple sex partners, infection with another STD at the same time or previous STD infection, and not using a condom correctly and consistently.
Encounter For Screening For Other Infectious And Parasitic Diseases
- 2016201720182019202020212022Billable/Specific CodePOA Exempt
- Z11.8 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes.
- Short description: Encounter for screening for oth infec/parastc diseases
- The 2022 edition of ICD-10-CM Z11.8 became effective on October 1, 2021.
- This is the American ICD-10-CM version of Z11.8 – other international versions of ICD-10 Z11.8 may differ.
- Encounter for screening for chlamydia
- Encounter for screening for rickettsial
- Encounter for screening for spirochetal
- Encounter for screening for mycoses
- Applicable To annotations, or
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