Is Z43.6 a billable ICD-10-CM code?

Yes. Z43.6 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does Z43.6 sit in the tabular list?

Factors influencing health status and contact with health services (Z00-Z99), in the block Encounters for other specific health care (Z40-Z53).

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.

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

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.

Medicare coverage

Z43.6 is named in 1 Medicare coverage policy — 1 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

A52487Ostomy Supplies - Policy Article

How Z43.6 is indexed

Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to Z43.6.

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

Related codes at this level

Codes that share Z43. If Z43.6 is not quite right, the correct code is usually one of these.

Questions about Z43.6

Is Z43.6 a billable ICD-10-CM code?: Yes. Z43.6 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does Z43.6 sit in the tabular list?: Factors influencing health status and contact with health services (Z00-Z99), in the block Encounters for other specific health care (Z40-Z53).