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Z43 vs Z48

Z43 (Encounter for attention to artificial openings) compared with Z48 (Encounter for other postprocedural aftercare), 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. Z48 carries an Excludes2 note covering Z43: “encounter for attention to artificial openings (Z43.-)”

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

Side by side

Z43Encounter for attention to artificial openingsZ48Encounter for other postprocedural aftercare
Billing statusNon-billable header

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

Non-billable header

Report instead: Z48.00, Z48.01, Z48.02, Z48.03, Z48.1

ClassificationZ00-Z99 — Factors Influencing Health Status and Contact with Health Services (Z00-Z99)Z00-Z99 — Factors Influencing Health Status and Contact with Health Services (Z00-Z99)
DefinitionEncounter for attention to artificial openings is a non-billable ICD-10-CM category code (Z43).Encounter for other postprocedural aftercare is a non-billable ICD-10-CM category code (Z48).
Includes
closure of artificial openings
passage of sounds or bougies through artificial openings
reforming artificial openings
removal of catheter from artificial openings

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