{"code":"Z31.43","type":"code","title":"Encounter for genetic testing of female for procreative management","codeAlso":[],"includes":[],"modern_v":"official26","codeFirst":[],"excludes1":["nonprocreative genetic testing (Z13.7-)","postvasectomy sperm count (Z30.8)"],"excludes2":["complications associated with artificial fertilization (N98.-)","female infertility (N97.-)","male infertility (N46.-)"],"isBillable":false,"fyEffectivity":{"fy2026":true,"fy2027":true,"billableFy2026":false,"billableFy2027":false},"sibling_codes":["Z31.430","Z31.438"],"inclusionTerms":[],"sibling_titles":{"code":"Z31.438","title":"Encounter for other genetic testing of female for procreative management","isBillable":true},"useAdditionalCode":["code for recurrent pregnancy loss, if applicable (N96, O26.2-)"],"clinicalDefinition":"Encounter for genetic testing of female for procreative management is a non-billable ICD-10-CM category code (Z31.43). A more specific billable subcode must be selected for claims submission. Excludes1 (not coded here): nonprocreative genetic testing (Z13.7-); postvasectomy sperm count (Z30.8). Excludes2 (not included here): complications associated with artificial fertilization (N98.-); female infertility (N97.-); male infertility (N46.-). Use additional code: code for recurrent pregnancy loss, if applicable (N96, O26.2-).","officialDefinition":"Encounter for genetic testing of female for procreative management is a non-billable ICD-10-CM category code (Z31.43). A more specific billable subcode must be selected for claims submission. Excludes1 (not coded here): nonprocreative genetic testing (Z13.7-); postvasectomy sperm count (Z30.8). Excludes2 (not included here): complications associated with artificial fertilization (N98.-); female infertility (N97.-); male infertility (N46.-). Use additional code: code for recurrent pregnancy loss, if applicable (N96, O26.2-).","seventhCharacterInstructions":[],"workflowProtocols":[],"guidelines":{"whenToUse":[],"whenNotToUse":[],"commonBillingMistakes":[],"codeComparisons":[],"documentationChecklist":[]},"domainLandscape":{"summary":"Primary diagnostic domain and clinical landscape evaluation.","keyCategories":[],"diagnosticContinuum":"Progression continuum from acute presentation to resolution."},"children":[],"hierarchy":[],"relatedCodes":[],"relevantCPTCodes":[],"documentationTips":[],"caseStudies":[],"description":"","overview":"","noteProvenance":{"complications associated with artificial fertilization (N98.-)":"Z31","female infertility (N97.-)":"Z31","male infertility (N46.-)":"Z31","postvasectomy sperm count (Z30.8)":"Z31.4"},"hcc":{"mapped":false,"model":"CMS-HCC V28","paymentYear":"2026","categories":[],"otherModels":[]}}