Skip to main content

Z31.430 ICD-10-CM Code: Encounter of female for testing for genetic disease carrier status for procreative management

Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.

Coding at a Glance

Tabular directives
2 Excludes1 · 3 Excludes2 · 1 use-additional code

Inpatient Payment Groups (MS-DRG)

Potential MS-DRG participation — not a DRG assignment.

MS-DRGs this diagnosis helps define, as principal or secondary, per the CMS ICD-10-CM/PCS MS-DRG Definitions Manual v43, Appendix B.

  • MS-DRG 951 — OTHER FACTORS INFLUENCING HEALTH STATUS (MDC 23)

A diagnosis appearing in a group's logic does not by itself determine the DRG assigned to a stay; the grouper uses the full claim.

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for Z31.430 in the official ICD-10-CM tabular list, quoted as published.

Notes without a marker are published on Z31.430 itself; “inherited from” names the category or block whose note applies here.

Excludes1 — Not Coded Here

Conditions generally not reported together with this code (Excludes1) -- an error unless the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).

Excludes2 — Not Included Here

Conditions not covered by this code, but which may be reported alongside it when both are present.

Source: inherited from Z31

Use Additional Code

Supplementary codes the tabular list directs you to add.

  • Use additional code for recurrent pregnancy loss, if applicable (N96, O26.2-)

Source: inherited from Z31.43

Coder workflow for Z31.430

MedCoder structured workflow — derived from this code’s own official record

Before you code Z31.430

  1. Confirm the reason for the encounter this Z code records: the circumstance it records. Check whether the code may be reported as first-listed or principal — some Z codes are limited to one position — and do not report a history or status code for a condition documented as current. Z code categories and their reporting positions (Guidelines I.C.21.c, I.C.21.c.15).

    Guide: Z codes as principal or first-listed diagnosis →

  2. Check the Excludes1 note: if the documentation supports a condition named there, do not simply proceed with Z31.430. Excludes1 conditions are not reported together with this code unless the record shows they are unrelated (Guidelines I.A.12.a).

    See the official tabular notes

Choose the right path

  1. Does the documentation support a condition named in Z31.430’s Excludes1 note?
    Yes → Do not simply proceed: review the excluded code. Both are reported only when the record shows the two conditions are unrelated.
    No → Continue.

    ReviewZ13.7, Z30.8

Consider Z31.430. Then work the Use Additional Code note, and confirm the code is valid for the date of service in the Verify section.

Documentation check

The provider’s diagnostic statement
Codes are assigned from the provider’s documented diagnosis, not from clinical criteria, test values or a medication list (Guidelines I.A.19).
The conditions the Use Additional Code note names
Reported with this code when documented; a conditional instruction (“if applicable”, “if known”) applies only when the record supports it.
The reason for the encounter
Whether the code records the encounter’s purpose, a status, or a history — and whether it may be first-listed (Guidelines I.C.21.c).

Official instructions as workflow

  • Excludes1 — check before selecting Z31.430(2 notes)

    Coding workflow: If the documentation supports a condition named in this note, do not simply proceed with Z31.430: the two are not reported together. The one exception is when the record shows the two conditions are unrelated to each other.

    CompareZ13.7, Z30.8

    See the official tabular notes · Guidelines I.A.12.a

  • Excludes2 — not part of Z31.430(3 notes)

    Coding workflow: The conditions named in this note are not included in Z31.430. When the record documents both, both may be reported; the note is a boundary, not a prohibition.

    CompareN98, N97, N46

    See the official tabular notes · Guidelines I.A.12.b

  • Use Additional Code — after identifying Z31.430(1 note)

    Coding workflow: Check whether the documentation supports the additional code(s) the note names, and report them with Z31.430 when it does. Where the instruction is conditional (“if applicable”, “if known”), it applies only when the record documents the condition.

    ReviewN96, O26.2

    See the official tabular notes · Guidelines I.A.13

Coding decision scenarios

Pattern scenarios for this code’s structure — decision rules, not clinical cases

Documentation: Both the condition Z31.430 describes and a condition named in its Excludes1 note are documented for the same encounter.

Coding question: Can both codes be reported?

Path: Review the Excludes1 note and the excluded code, and look for a provider statement on whether the two conditions are related.

Reason: Excludes1 means the two are not coded together; the exception is when the record shows the conditions are unrelated to each other (Guidelines I.A.12.a).

ReviewZ13.7, Z30.8

Documentation: A condition the Use Additional Code note names is documented.

Coding question: Is a second code reported with Z31.430?

Path: Review the Use Additional Code note and the code it names.

Reason: The additional code is reported when the record documents the condition; a conditional instruction applies only when its condition is met (Guidelines I.A.13).

ReviewN96, O26.2

Every row is derived from this code’s own record — its title, tabular notes, 7th-character family and same-category siblings — with fixed MedCoder wording; nothing is inferred about a patient. The official notes and guideline text are in the sections each row links to, and they control.

Code Overview

Encounter of female for testing for genetic disease carrier status for procreative management is a billable ICD-10-CM diagnosis code (Z31.430).

MedCoder summary Summary composed by MedCoder from this code's official ICD-10-CM record. The tabular instructional notes themselves appear verbatim below.

Indexed Clinical Terms (1)

Official source data — entries quoted as published, in the Index’s own lookup phrasing

Clinical term phrases from the official ICD-10-CM Index to Diseases and Injuries that map to this code. These are alphabetic-index entries shown as the Index writes them — lookup phrasing, not necessarily the wording of a final diagnosis.

Official Coding Guidelines

Official source data — quoted verbatim from the CMS/NCHS Official Guidelines

Official source data — quoted verbatim from the CMS/NCHS Official Guidelines

Verbatim excerpts from the ICD-10-CM Official Guidelines for Coding and Reporting (CMS/NCHS) that govern this code.

Chapter 21: Factors influencing health status and contact with health services (Z00-Z99)

Z codes/categories for obstetrical and reproductive services: Z30 Encounter for contraceptive management Z31 Encounter for procreative management Z32.2 Encounter for childbirth instruction Z32.3 Encounter for childcare instruction Z33 Pregnant state Z34 Encounter for supervision of normal pregnancy Z36 Encounter for antenatal screening of mother Z3A Weeks of gestation Z37 Outcome of delivery Z39 Encounter for maternal postpartum care and examination Z76.81 Expectant mother prebirth pediatrician visit

Decision Points

The directives on this code's own record, as a pre-claim checklist.

  1. 1 Use Additional Code instruction — report the named additional code(s) when the documentation supports them. See the Use Additional Code notes
  2. 2 Excludes1 entries — codes named there are generally not reported together with this code (Guidelines I.A.12.a). See the Excludes1 notes
  3. 3 Excludes2 entries — those conditions are not part of this code and may be reported additionally when documented. See the Excludes2 notes

Checklist rows are derived from this code's own official directives; the wording of each check is MedCoder editorial. The official notes themselves are in the sections each row links to.

Verify Before Coding

  • Principal-diagnosis restriction. The Medicare Code Editor lists this code as unacceptable as a principal diagnosis: it describes a circumstance influencing health status rather than a current illness or injury being treated. It is valid as a secondary diagnosis.

From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim in Claim Check.

Relationships & Classification

MedCoder structured relationships — computed from published CMS and AHRQ datasets

Other codes that name Z31.430 or its code family, from the CMS ICD-10-CM tabular instructional notes. Tabular-note edges are stored at the code family level that carries each note.

Referenced by 1 Excludes1 note: Z13.7 — Encounter for screening for genetic and chromosomal anomalies (via Z31.4.-).

These codes’ tabular lists mark this diagnosis as mutually exclusive — not reported together unless the conditions are documented as unrelated.

Referenced by 15 Excludes2 notes: Z00 — Encounter for general examination without complaint, suspected or reported diagnosis (via Z31.-), Z00-Z13 — Persons encountering health services for examinations (Z00-Z13) (via Z31.-), Z01 — Encounter for other special examination without complaint, suspected or reported diagnosis (via Z31.-), Z02 — Encounter for administrative examination (via Z31.-), Z03 — Encounter for medical observation for suspected diseases and conditions ruled out (via Z31.-), Z04 — Encounter for examination and observation for other reasons (via Z31.-), Z05 — Encounter for observation and evaluation of newborn for suspected diseases and conditions ruled out (via Z31.-), Z08 — Encounter for follow-up examination after completed treatment for malignant neoplasm (via Z31.-), Z09 — Encounter for follow-up examination after completed treatment for conditions other than malignant neoplasm (via Z31.-), Z11 — Encounter for screening for infectious and parasitic diseases (via Z31.-), Z12 — Encounter for screening for malignant neoplasms (via Z31.-), Z13 — Encounter for screening for other diseases and disorders (via Z31.-), Z36 — Encounter for antenatal screening of mother (via Z31.43.-), Z70 — Counseling related to sexual attitude, behavior and orientation (via Z31.-), Z71 — Persons encountering health services for other counseling and medical advice, not elsewhere classified (via Z31.-).

These codes’ tabular lists name this diagnosis as distinct — both may be reported when both are documented.

MS-DRG Grouper Relationships (FY2026)

Potential MS-DRG participation — not a DRG assignment.

Not on the CMS CC/MCC list — as a secondary diagnosis this code does not change MS-DRG severity.

Named in the grouper logic of 1 MS-DRG: DRG 951 (MDC 23).

From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.

Clinical classification (AHRQ CCSR):FAC013 — Contraceptive and procreative management (default).

Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.

Related Codes

Principal diagnosis restriction (Medicare Code Editor)

Not acceptable as a principal diagnosis on an inpatient claim.

Same clinical category (CCSR)

AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical category (Contraceptive and procreative management).

Z30.433 — Encounter for removal and reinsertion of intrauterine contraceptive device, Z30.44 — Encounter for surveillance of vaginal ring hormonal contraceptive device, Z30.45 — Encounter for surveillance of transdermal patch hormonal contraceptive device, Z30.46 — Encounter for surveillance of implantable subdermal contraceptive, Z30.49 — Encounter for surveillance of other contraceptives, Z30.8 — Encounter for other contraceptive management, Z30.9 — Encounter for contraceptive management, unspecified, Z31.0 — Encounter for reversal of previous sterilization, Z31.41 — Encounter for fertility testing, Z31.42 — Aftercare following sterilization reversal, Z31.438 — Encounter for other genetic testing of female for procreative management, Z31.440 — Encounter of male for testing for genetic disease carrier status for procreative management, Z31.441 — Encounter for testing of male partner of patient with recurrent pregnancy loss, Z31.448 — Encounter for other genetic testing of male for procreative management, Z31.49 — Encounter for other procreative investigation and testing, Z31.5 — Encounter for procreative genetic counseling, Z31.61 — Procreative counseling and advice using natural family planning, Z31.62 — Encounter for fertility preservation counseling, Z31.69 — Encounter for other general counseling and advice on procreation, Z31.7 — Encounter for procreative management and counseling for gestational carrier, +27 more

Same Index main term, other category

The ICD-10-CM Index to Diseases and Injuries files this code under the main term “Test, tests, testing”; these codes share that main term but sit in a different category of the Tabular List.

Z00.129 — Encounter for routine child health examination without abnormal findings (vision, infant or child), Z01.00 — Encounter for examination of eyes and vision without abnormal findings (vision), Z01.01 — Encounter for examination of eyes and vision with abnormal findings (vision, with abnormal findings), Z01.020 — Encounter for examination of eyes and vision following failed vision screening without abnormal findings (vision, following failed vision screening), Z01.021 — Encounter for examination of eyes and vision following failed vision screening with abnormal findings (vision, following failed vision screening, with abnormal findings), Z01.10 — Encounter for examination of ears and hearing without abnormal findings (hearing), Z01.118 — Encounter for examination of ears and hearing with other abnormal findings (hearing, with abnormal findings NEC), Z01.30 — Encounter for examination of blood pressure without abnormal findings (blood pressure), Z01.82 — Encounter for allergy testing (skin, diagnostic, allergy), Z01.83 — Encounter for blood typing (blood typing), Z01.84 — Encounter for antibody response examination (immunity status), Z01.89 — Encounter for other specified special examinations (specified NEC), Z02.83 — Encounter for blood-alcohol and blood-drug test (blood-drug), Z04.89 — Encounter for examination and observation for other specified reasons (laboratory, for medicolegal reason NEC), Z11.1 — Encounter for screening for respiratory tuberculosis (Mantoux), Z11.3 — Encounter for screening for infections with a predominantly sexual mode of transmission (Wassermann), Z21 — Asymptomatic human immunodeficiency virus [HIV] infection status (HIV, positive), Z45.010 — Encounter for checking and testing of cardiac pacemaker pulse generator [battery] (cardiac pulse generator), Z49.31 — Encounter for adequacy testing for hemodialysis (adequacy, hemodialysis), Z49.32 — Encounter for adequacy testing for peritoneal dialysis (adequacy, peritoneal), +5 more

Contextual Map

Every relationship of Z31.430 in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.

Run Z31.430 with these 9 related codes in Claim Check

Hierarchy

Referenced by Excludes1 notes

Referenced by Excludes2 notes (15)

Clinical classification (CCSR)

MS-DRG Grouper

MDC crossing

  • MDC 23 — Factors Influencing Health Status and Other Contacts with Health Services[MDC crossing]: “Factors Influencing Health Status and Other Contacts with Health Services — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs. 1,235 same-MDC procedures group here; browse them on the MDC page.”— CMS MS-DRG Definitions Manual · FY2026

Index entries

  • Test, tests, testing (for), genetic, disease carrier status for procreative management, female[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026

Nearest codes (25)

Change history

  • FY2016 — In the code set at ICD-10-CM adoption [Change history]— CMS release files (code change ledger) · icd10cm-fy2016

Sources for this page

Codes, titles, notes, index terms and mappings on this page are transcribed from the datasets below. Relationships MedCoder computed and text MedCoder wrote are labelled where they appear.

Code, title, tabular notes and index terms Official source data
CMS/CDC ICD-10-CM FY2026 tabular list, index and tables, effective October 1, 2025 Release, file and checksum · Publisher’s page
Coding guidelines Official source data
ICD-10-CM Official Guidelines for Coding and Reporting (FY2026), quoted by section Release, file and checksum · Publisher’s page
Claim edits Official source data
CMS Definitions of Medicare Code Edits — v43.1 (April 2026) Release, file and checksum · Publisher’s page
Inpatient payment groups Official source data
CMS MS-DRG Definitions Manual (incl. Appendix B diagnosis index, Appendix C CC/MCC list, Appendix E procedure index) and IPPS Final Rule tables — v43 Release, file and checksum · Publisher’s page
Change history and date-of-service validity Official source data
CMS ICD-10-CM release addenda, ingested release by release into the change ledger Release, file and checksum · Publisher’s page
Comparisons, relationships and the contextual map MedCoder structured relationship
Computed by MedCoder from the tabular notes and tables above; every derived relationship is marked as derived where it appears
Summary and FAQ answers MedCoder explanation
Written by MedCoder to explain the sources above: drafted with AI assistance, checked by a person against the release files, and labelled as MedCoder text where it appears. Not official text.

Labels on this page: Official source data · MedCoder structured relationship · MedCoder explanation. How to read the labels · All data sources and release dates

Change history

  • FY2016 — October 1, 2015
    In the code set at ICD-10-CM adoption
    Encounter of female for testing for genetic disease carrier status for procreative management

No changes since FY2016 — additions, deletions, description changes and billable-status changes are tracked through FY2027 (effective October 1, 2026), and none are recorded for this code. Note changes are tracked from FY2027 only.

Nearest Codes in This Family

Official ICD-10-CM classifications closest to Z31.430 in its code family, with their registry titles.

View all codes in the Z31 family