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Compare/T80.62XA vs Z43

T80.62XA vs Z43

T80.62XA (Other serum reaction due to vaccination, initial encounter) compared with Z43 (Encounter for attention to artificial openings), from the official CMS tabular data. Both may be reported when both conditions are documented (Excludes2).

Can these codes be reported together?

Yes, when both are documented. T80.62XA carries an Excludes2 note covering Z43: “closure of external stoma (Z43.-)”

Excludes2 marks distinct conditions — both may be reported when both are documented.

Side by side

T80.62XAOther serum reaction due to vaccination, initial encounterZ43Encounter for attention to artificial openings
Billing statusBillableNon-billable header

Report instead: Z43.0, Z43.1, Z43.2, Z43.3, Z43.4

ClassificationS00-T88 — Injury, Poisoning and Certain Other Consequences of External Causes (S00-T88)Z00-Z99 — Factors Influencing Health Status and Contact with Health Services (Z00-Z99)
DefinitionOther serum reaction due to vaccination, initial encounter is a billable ICD-10-CM diagnosis code (T80.62A).Encounter for attention to artificial openings is a non-billable ICD-10-CM category code (Z43).
7th characterThe appropriate 7th character is to be added to each code from category T80
Includes
complications following perfusion
closure of artificial openings
passage of sounds or bougies through artificial openings
reforming artificial openings
removal of catheter from artificial openings
Use additional code
code for adverse effect, if applicable, to identify drug (T36-T50 with fifth or sixth character 5)
code(s) to identify the specified condition resulting from the complication
code to identify devices involved and details of circumstances (Y62-Y82)

Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources