Z43.6

Z43.6: Encounter for attention to other artificial openings of urinary tract

Billable / specific codeICD-10-CMPOA exempt

Z43.6 is a billable, specific ICD-10-CM code for encounter for attention to other artificial openings of urinary tract. It is valid for submission on a claim.

Check Z43.6 with the rest of the claim: free scrubber

Inclusion terms

Alternative wordings a physician may use in the chart for this same code.

Encounter for attention to nephrostomy
Encounter for attention to ureterostomy
Encounter for attention to urethrostomy

Excludes1 inherited from the categories above Z43.6

A category’s note binds every code beneath it.

Written on Z43: Encounter for attention to artificial openings

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

Excludes2 inherited from the categories above Z43.6

Not part of this code, but both may be coded when both are present.

Written on Z43: Encounter for attention to artificial openings

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

Other codes that can never be billed with Z43.6

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

Z93Artificial opening status

Risk adjustment

Z43.6 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:

HCC 463 Artificial Openings for Feeding or Elimination0.673 RAF

Coefficient shown for the Community Non-dual Aged segment. A higher HCC in the same hierarchy will suppress this one, so capturing it does not always add score. Look up the whole chart to see which of its HCCs the hierarchy would zero.

Medicare coverage

Z43.6 is named in 1 Medicare coverage policy: 1 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.

A52487Ostomy Supplies - Policy Article

Alphabetic index entries that lead here

Attention›nephrostomy
Attention›ureterostomy
Attention›urethrostomy
Nephrostomy›attention to
Ureterostomy›attention to
Urethrostomy›attention to
Admission›attention to artificial opening›nephrostomy
Admission›attention to artificial opening›ureterostomy
Admission›attention to artificial opening›urethrostomy
Admission›attention to artificial opening›specified site NEC›urinary tract
Attention›artificial›opening›urinary tract NEC
Attention›artificial›opening›urinary tract NEC›nephrostomy

Code history

Unchanged in every release from FY2024 to FY2027.