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Z49.31 ICD-10-CM Code: Encounter for adequacy testing for hemodialysis

Compare with another codeCheck this code on a claim

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

Coding at a Glance

Tabular directives
1 Excludes2 · 1 code-also instruction
Risk adjustment
CMS-HCC V22 category 134 · RxHCC V08 category 261

Billable · FY2027A valid, specific ICD-10-CM code, reportable for dates of service in FY2027.

What you need to know

Source: CMS/NCHS Official ICD-10-CM tabular notes, quoted. From the CMS/NCHS tabular list for the release in force. A note the category or block publishes applies to this code too; the Instructions section marks which is which.

Code alsoMay be needed with this code
  • associated end stage renal disease (N18.6)
Excludes2Not included here; may be reported together
  • follow-up examination for medical surveillance after treatment (Z08-Z09)

Most relevant related codes MedCoder-derived

Read off the official notes above and this code’s own position in the tabular list. Which to report is a documentation question; Compare shows the two side by side.

CompareCheck ClaimView Related Codes

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 v44, Appendix B.

  • MS-DRG 698 — OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MCC (MDC 11)
  • MS-DRG 699 — OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH CC (MDC 11)
  • MS-DRG 700 — OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITHOUT CC/MCC (MDC 11)

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 Z49.31 in the official ICD-10-CM tabular list, quoted as published.

Source: CMS/CDC — ICD-10-CM Tabular ListRelease: FY2027Effective: October 1, 2026

Trace:FY2027 changesChange historyRelease, file and checksum

Notes without a marker are published on Z49.31 itself; “inherited from” names the category or block whose note applies here.

Excludes2 — Not Included Here

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

Source: inherited from Z40-Z53

Code Also

Additional codes that may be required to fully describe the encounter.

  • associated end stage renal disease (N18.6)

Source: inherited from Z49

Coder workflow for Z49.31

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

Before you code Z49.31

  1. Confirm the reason for the encounter this Z code records: aftercare or a therapy encounter after the initial treatment of a disease or injury. 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.7, I.C.21.c.15).

    Guide: Aftercare vs follow-up →

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 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

  • Excludes2 — not part of Z49.31(1 note)

    Coding workflow: The conditions named in this note are not included in Z49.31. When the record documents both, both may be reported; the note is a boundary, not a prohibition.

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

  • Code Also — related condition(1 note)

    Coding workflow: Review the related condition when both are documented and the instruction applies. A Code Also note does not fix sequencing; the order follows the circumstances of the encounter.

    ReviewN18.6

    See the official tabular notes · Guidelines I.A.17

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.

Don’t confuse Z49.31 with…

MedCoder analysis — pairs from this code’s official notes, distinctions written by MedCoder

The codes most likely to be picked instead of Z49.31 — named in its own official notes, or sharing its laterality or encounter family — with what separates them and which documentation moves the case. Each links to the full comparison.

  • Z08— Excludes2 relationship (Informational)

    Distinct conditions — both may be reported.

    A distinct condition — both may be reported when both are documented.

    What moves you there: Documentation of follow-up examination for medical surveillance after treatment adds Z08; it is not part of this code and both may be reported when both are documented.

    Full comparison: Z49.31 vs Z08 →

  • Z09— Excludes2 relationship (Informational)

    Distinct conditions — both may be reported.

    A distinct condition — both may be reported when both are documented.

    What moves you there: Documentation of follow-up examination for medical surveillance after treatment adds Z09; it is not part of this code and both may be reported when both are documented.

    Full comparison: Z49.31 vs Z09 →

Relationships are read from this code's own official notes, its laterality siblings and its encounter family; the wording of each distinction is MedCoder editorial, and the documentation named in each “what moves you there” line is the official note phrase or sibling title itself. Source: CMS ICD-10-CM tabular instructional notes; ICD-10-CM Official Guidelines, Section I.A.12.a.

Coding context

Guidelines, coding notes, decision aids, relationships (with MS-DRG and CCSR classification), hierarchy, HCC, coverage and the context map: what a coder reaches for after the core. Each section names whether it is official source data, a MedCoder-derived relationship or MedCoder editorial.

Code Overview

Encounter for adequacy testing for hemodialysis is a billable ICD-10-CM diagnosis code (Z49.31).

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

Official Coding 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)

The aftercare codes are generally found in the following categories: Z42 Encounter for plastic and reconstructive surgery following medical procedure or healed injury Z43 Encounter for attention to artificial openings Z44 Encounter for fitting and adjustment of external prosthetic device Z45 Encounter for adjustment and management of implanted device Z46 Encounter for fitting and adjustment of other devices Z47 Orthopedic aftercare Z48 Encounter for other postprocedural aftercare Z49 Encounter for care involving renal dialysis Z51 Encounter for other aftercare and medical care

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-derived relationships — computed from published CMS and AHRQ datasets

Other codes that name Z49.31 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 2 Excludes1 notes: Z08 — Encounter for follow-up examination after completed treatment for malignant neoplasm (via Z49.-), Z09 — Encounter for follow-up examination after completed treatment for conditions other than malignant neoplasm (via Z49.-).

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

Referenced by 1 Excludes2 note: Z98 — Other postprocedural states (via Z49.-).

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

MS-DRG Grouper Relationships (FY2027)

Potential MS-DRG participation — not a DRG assignment.

FY2027 MS-DRG: not on the CMS CC/MCC list — as a secondary diagnosis this code does not change MS-DRG severity for that release.

Named in the grouper logic of 3 MS-DRGs: DRG 698 (MDC 11), DRG 699 (MDC 11), DRG 700 (MDC 11).

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

Clinical classification (AHRQ CCSR):FAC010 — Other aftercare encounter; GEN003 — Chronic kidney disease (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 categories (Other aftercare encounter, Chronic kidney disease).

Z48.288 — Encounter for aftercare following multiple organ transplant, Z48.290 — Encounter for aftercare following bone marrow transplant, Z48.298 — Encounter for aftercare following other organ transplant, Z48.810 — Encounter for surgical aftercare following surgery on the sense organs, Z48.811 — Encounter for surgical aftercare following surgery on the nervous system, Z48.812 — Encounter for surgical aftercare following surgery on the circulatory system, Z48.813 — Encounter for surgical aftercare following surgery on the respiratory system, Z48.814 — Encounter for surgical aftercare following surgery on the teeth or oral cavity, Z48.815 — Encounter for surgical aftercare following surgery on the digestive system, Z48.816 — Encounter for surgical aftercare following surgery on the genitourinary system, Z48.817 — Encounter for surgical aftercare following surgery on the skin and subcutaneous tissue, Z48.89 — Encounter for other specified surgical aftercare, Z49.01 — Encounter for fitting and adjustment of extracorporeal dialysis catheter, Z49.02 — Encounter for fitting and adjustment of peritoneal dialysis catheter, Z49.32 — Encounter for adequacy testing for peritoneal dialysis, Z51.5 — Encounter for palliative care, Z51.6 — Encounter for desensitization to allergens, Z51.81 — Encounter for therapeutic drug level monitoring, Z51.89 — Encounter for other specified aftercare, Z51.A — Encounter for sepsis aftercare, +52 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.

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), Z31.41 — Encounter for fertility testing (fertility), Z31.430 — Encounter of female for testing for genetic disease carrier status for procreative management (genetic, disease carrier status for procreative management, female), Z31.438 — Encounter for other genetic testing of female for procreative management (genetic, procreative management NEC, female), Z31.440 — Encounter of male for testing for genetic disease carrier status for procreative management (genetic, disease carrier status for procreative management, male), Z31.441 — Encounter for testing of male partner of patient with recurrent pregnancy loss (male partner of patient with recurrent pregnancy loss), Z31.448 — Encounter for other genetic testing of male for procreative management (genetic, procreative management NEC, male), Z31.49 — Encounter for other procreative investigation and testing (procreative), Z45.010 — Encounter for checking and testing of cardiac pacemaker pulse generator [battery] (cardiac pulse generator), +10 more

Lab tests where this diagnosis supports Medicare coverage (NCD)

Medicare's National Coverage Determination (NCD) program lists this diagnosis as medical justification for these lab tests.

Iron Panel

Contextual Map

Every relationship of Z49.31 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 Z49.31 with these 3 related codes in Claim Check

Hierarchy

Referenced by Excludes1 notes

Referenced by Excludes2 notes

Clinical classification (CCSR)

MS-DRG Grouper

MDC crossing

  • MDC 11 — Diseases and Disorders of the Kidney and Urinary Tract[MDC crossing]: “Diseases and Disorders of the Kidney and Urinary Tract — 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. 3,578 same-MDC procedures group here; browse them on the MDC page.”— CMS MS-DRG Definitions Manual · FY2027

Index entries

  • Test, tests, testing (for), adequacy (for dialysis), hemodialysis[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027

Nearest codes

Change history

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

Reference

Index terms and tables, published questions and FAQ, every source behind this page with its release and checksum, the date-of-service check and the complete change history.

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.

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 FY2027 tabular list, index and tables, effective October 1, 2026 Release, file and checksum · Publisher’s page
Coding guidelines Official source data
ICD-10-CM Official Guidelines for Coding and Reporting (FY2027), quoted by section Release, file and checksum · Publisher’s page
Claim edits Official source data
CMS Definitions of Medicare Code Edits — v44.0 (October 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 — v44 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-derived 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 editorial 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.

Current data releases:ICD-10-CM FY2027 · ICD-10-PCS FY2027 · HCPCS October 2026 · MS-DRG v44 · Medicare Code Editor v44.0 · NCCI PTP Q4 2026 · MUE Q4 2026 · NCD code lists 2026-01 · LCD export September 20, 2026 · All releases and sources

Labels on this page: Official source data · MedCoder-derived relationship · MedCoder editorial explanation. How to read the labels · All data sources and release dates · CMS coding rules

Cite this page

Reference this page in a research guide, syllabus or article. The release is included because code content changes each year.

MedCoder.ai. "Z49.31 — Encounter for adequacy testing for hemodialysis." ICD-10-CM FY2027. https://medcoder.ai/icd10/code/z49.31-encounter-for-adequacy-testing-for-hemodialysis

Change history

  • FY2016 — October 1, 2015
    In the code set at ICD-10-CM adoption
    Encounter for adequacy testing for hemodialysis

No changes since FY2016 — additions, deletions, description changes and billable-status changes are tracked through FY2027, 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 Z49.31 in its code family, with their registry titles.

View all codes in the Z49 family