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v1.0.0
ICD-10 Guide
ICD-10 CodesZ31.0

Z31.0

Encounter for reversal of previous sterilization

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/12/2025

Code Description

ICD-10 Z31.0 is a billable code used to indicate a diagnosis of encounter for reversal of previous sterilization.

Key Diagnostic Point:

Z31.0 is used to document encounters for the reversal of previous sterilization procedures. This code is relevant in clinical contexts where patients seek to regain fertility after undergoing sterilization, which may have been a permanent decision at the time. Factors influencing health status include the patient's age, reproductive health history, and social determinants such as marital status, socioeconomic status, and access to healthcare services. Preventive care considerations involve counseling on fertility options, potential risks of reversal procedures, and the importance of pre-operative assessments. Screening for underlying reproductive health issues is also critical. Aftercare may include follow-up visits to monitor recovery and fertility outcomes. Understanding these factors is essential for accurate coding and ensuring comprehensive patient care.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Need for thorough documentation of previous sterilization history
  • Assessment of patient motivation and psychological readiness for reversal
  • Potential complications and risks associated with the reversal procedure
  • Variability in payer requirements for coverage of reversal procedures

Audit Risk Factors

  • Inadequate documentation of the patient's previous sterilization procedure
  • Failure to document counseling provided regarding risks and benefits
  • Lack of follow-up documentation post-reversal
  • Incorrect sequencing of codes related to fertility treatments

Specialty Focus

Medical Specialties

Primary Care

Documentation Requirements

Documentation should include patient history, reasons for seeking reversal, and any counseling provided.

Common Clinical Scenarios

Routine checkups where patients express interest in fertility options, pre-operative assessments, and post-operative follow-ups.

Billing Considerations

Consideration of social determinants such as the patient's support system, financial resources, and access to fertility specialists.

Public Health

Documentation Requirements

Documentation should include population-level data on sterilization and reversal rates, as well as health outcomes.

Common Clinical Scenarios

Epidemiological studies on the impact of sterilization and reversal on community health.

Billing Considerations

Tracking health disparities related to access to reversal procedures among different populations.

Coding Guidelines

Inclusion Criteria

Use Z31.0 When
  • Z codes are used to indicate encounters for reasons other than illness or injury
  • 0 should be sequenced appropriately, often as a secondary code following a primary diagnosis related to the patient's health status
  • Payer requirements may vary, so it is essential to verify coverage for reversal procedures

Exclusion Criteria

Do NOT use Z31.0 When
No specific exclusions found.

Related CPT Codes

58661CPT Code

Laparoscopic tubal reversal

Clinical Scenario

Used when performing a laparoscopic procedure to reverse a tubal ligation.

Documentation Requirements

Pre-operative assessments, consent forms, and post-operative follow-up notes.

Specialty Considerations

Considerations for surgical specialties and the need for collaboration with fertility specialists.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for greater specificity in coding encounters for reversal of sterilization, improving the ability to capture patient needs and outcomes accurately.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for greater specificity in coding encounters for reversal of sterilization, improving the ability to capture patient needs and outcomes accurately.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for greater specificity in coding encounters for reversal of sterilization, improving the ability to capture patient needs and outcomes accurately.

Resources

Clinical References

  • •
    American College of Obstetricians and Gynecologists (ACOG) Guidelines

Coding & Billing References

  • •
    American College of Obstetricians and Gynecologists (ACOG) Guidelines

Frequently Asked Questions

What documentation is required for Z31.0?

Documentation must include the patient's previous sterilization history, reasons for seeking reversal, counseling provided regarding risks and benefits, and any follow-up care plans.