Is Z31.43 a billable ICD-10-CM code?

No. Z31.43 is a non-billable header code. Code to a higher level of specificity using one of its child codes.

Where does Z31.43 sit in the tabular list?

Factors influencing health status and contact with health services (Z00-Z99), in the block Persons encountering health services in circumstances related to reproduction (Z30-Z39).

What cannot be coded together with Z31.43?

Z31.43 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.

Z31.43

Z31.43 — Encounter for genetic testing of female for procreative management

Non-billable headerICD-10-CM

Z31.43 is a non-billable header ICD-10-CM code for encounter for genetic testing of female for procreative management. It cannot be billed on its own: choose one of the more specific child codes below.

Excludes1 — never code together

These conditions cannot occur together. Billing both on the same encounter is a denial.

nonprocreative genetic testing (Z13.7-)

Use additional code

Add a secondary code to capture the detail described below.

code for recurrent pregnancy loss, if applicable (N96, O26.2-)

Risk adjustment

Z31.43 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.

Code to one of these instead Z31.43

2 child codes. Green means billable.

Related codes at this level

Codes that share Z31.4. If Z31.43 is not quite right, the correct code is usually one of these.

Questions about Z31.43

Is Z31.43 a billable ICD-10-CM code?: No. Z31.43 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
Where does Z31.43 sit in the tabular list?: Factors influencing health status and contact with health services (Z00-Z99), in the block Persons encountering health services in circumstances related to reproduction (Z30-Z39).
What cannot be coded together with Z31.43?: Z31.43 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.