Z43

Z43: Encounter for attention to artificial openings

Non-billable headerICD-10-CM

Z43 is a non-billable header ICD-10-CM code for encounter for attention to artificial openings. 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.

complications of external stoma (J95.0-, K94.-, N99.5-)

Excludes2: not included here, but may coexist

The excluded condition is not part of this code, but a patient can have both. You may code both.

fitting and adjustment of prosthetic and other devices (Z44-Z46)

Includes

Conditions this code covers.

closure of artificial openings
passage of sounds or bougies through artificial openings
reforming artificial openings
removal of catheter from artificial openings
toilet or cleansing of artificial openings

Other codes that can never be billed with Z43

Their own Excludes1 notes name this code, so the conflict is not listed above.

Z08Encounter for follow-up examination after completed treatment for malignant neoplasm
Z09Encounter for follow-up examination after completed treatment for conditions other than malignant neoplasm
Z93Artificial opening status
Z46.5Encounter for fitting and adjustment of other gastrointestinal appliance and device

Risk adjustment

No CMS-HCC V28 category: this code does not change a RAF score.

Code history

Unchanged in every release from FY2024 to FY2027.

Code to one of these instead Z43

10 child codes. Green means billable.