ICD-10 Guide

Z31.44

Encounter for genetic testing of male for procreative management

BILLABLE STATUSYes

IMPLEMENTATION DATEOctober 1, 2015

LAST UPDATED09/12/2025

Code Description

ICD-10 Z31.44 is a billable code used to indicate a diagnosis of encounter for genetic testing of male for procreative management.

Key Diagnostic Point:

Z31.44 is used to document encounters for genetic testing specifically aimed at procreative management in males. This testing is crucial for identifying genetic conditions that may affect offspring, allowing for informed reproductive choices. Factors influencing health status include genetic predispositions, family history, and environmental influences. Social determinants such as access to healthcare, education, and socioeconomic status can significantly impact a patient's decision to undergo genetic testing. Preventive care is emphasized as genetic testing can lead to early interventions and informed family planning. Screening for genetic conditions can help identify risks for conditions like cystic fibrosis or hemophilia, which may affect future generations. Aftercare may involve counseling and follow-up testing based on results, ensuring comprehensive management of reproductive health.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

Need for detailed family history documentation
Understanding of genetic terminology and implications
Coordination with genetic counseling services
Potential for multiple related diagnoses

Audit Risk Factors

Inadequate documentation of family history
Failure to link genetic testing to specific clinical indications
Misuse of Z codes without appropriate primary diagnosis
Lack of follow-up documentation post-testing

Specialty Focus

Medical Specialties

Primary Care

Documentation Requirements

Documentation should include patient history, reasons for testing, and any referrals to genetic counseling.

Common Clinical Scenarios

Routine checkups where genetic testing is discussed, referrals for testing based on family history.

Billing Considerations

Consideration of social determinants such as education level and access to genetic counseling services.

Public Health

Documentation Requirements

Documentation should include population health data, trends in genetic conditions, and surveillance of genetic testing outcomes.

Common Clinical Scenarios

Epidemiological studies assessing the prevalence of genetic disorders in specific populations.

Billing Considerations

Focus on health equity and access to genetic testing across diverse populations.

Coding Guidelines

Inclusion Criteria

Use Z31.44 When

Z codes are used when a patient encounters healthcare services for reasons other than a current illness or injury
44 should be sequenced appropriately, often as a secondary code following a primary diagnosis that necessitates genetic testing
Payer requirements may vary, so it is essential to verify coverage for genetic testing

Exclusion Criteria

Do NOT use Z31.44 When

No specific exclusions found.

Related CPT Codes

81200CPT Code

Genetic testing for cystic fibrosis

Clinical Scenario

Used in conjunction with Z31.44 when testing for specific genetic conditions.

Documentation Requirements

Documentation must include the reason for testing and any relevant family history.

Specialty Considerations

Primary care providers should ensure they have adequate knowledge of genetic testing implications.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for greater specificity in coding genetic testing encounters, improving the ability to track and manage genetic conditions effectively.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for greater specificity in coding genetic testing encounters, improving the ability to track and manage genetic conditions effectively.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for greater specificity in coding genetic testing encounters, improving the ability to track and manage genetic conditions effectively.

Resources

Clinical References

•
Genetic Testing Guidelines

Coding & Billing References

•
Genetic Testing Guidelines

Frequently Asked Questions

When should Z31.44 be used?

Z31.44 should be used when a male patient undergoes genetic testing specifically for procreative management, such as assessing risks for genetic conditions that may affect offspring.

ICD-10 Z31.44 is a billable code used to indicate a diagnosis of encounter for genetic testing of male for procreative management.