Z48.816

Z48.816: Encounter for surgical aftercare following surgery on the genitourinary system

Billable / specific codeICD-10-CMPOA exempt

Z48.816 is a billable, specific ICD-10-CM code for encounter for surgical aftercare following surgery on the genitourinary system. It is valid for submission on a claim.

Check Z48.816 with the rest of the claim: free scrubber

Excludes1: never code together

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

encounter for aftercare following sterilization reversal (Z31.42)

Excludes1 inherited from the categories above Z48.816

A category’s note binds every code beneath it.

Written on Z48.81: Encounter for surgical aftercare following surgery on specified body systems

aftercare for injury- code the injury with 7th character D
aftercare following surgery for neoplasm (Z48.3)

Written on Z48: Encounter for other postprocedural aftercare

encounter for follow-up examination after completed treatment (Z08-Z09)
encounter for aftercare following injury - code to Injury, by site, with appropriate 7th character for subsequent encounter

Excludes2 inherited from the categories above Z48.816

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

Written on Z48.81: Encounter for surgical aftercare following surgery on specified body systems

aftercare following organ transplant (Z48.2-)
orthopedic aftercare (Z47.-)

Written on Z48: Encounter for other postprocedural aftercare

encounter for attention to artificial openings (Z43.-)
encounter for fitting and adjustment of prosthetic and other devices (Z44-Z46)

Risk adjustment

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

Medicare coverage

Z48.816 is named in 1 Medicare coverage policy: 1 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.

A52399Billing and Coding: Denosumab (Prolia®, Xgeva®, Jubbonti®) and biosimilars