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ICD-10 Guide
ICD-10 CodesZ31.440

Z31.440

Encounter of male for testing for genetic disease carrier status for procreative management

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

Code Description

ICD-10 Z31.440 is a billable code used to indicate a diagnosis of encounter of male for testing for genetic disease carrier status for procreative management.

Key Diagnostic Point:

Z31.440 is used to document encounters where a male patient is being tested for genetic disease carrier status as part of procreative management. This testing is crucial for couples considering conception, as it helps identify potential genetic risks that could affect offspring. Factors influencing health status include family history of genetic disorders, ethnic background, and previous reproductive outcomes. Social determinants such as access to healthcare, education about genetic risks, and socioeconomic status can significantly impact the decision to undergo testing. Preventive care in this context involves proactive genetic counseling and screening to inform reproductive choices, while aftercare may include follow-up consultations to discuss results and implications for family planning.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Need for comprehensive family history documentation
  • Understanding of genetic terminology and implications
  • Coordination with genetic counseling services
  • Potential for multiple genetic tests and interpretations

Audit Risk Factors

  • Inadequate documentation of family history
  • Failure to document counseling provided
  • Misuse of Z codes without appropriate clinical context
  • Inconsistent coding across encounters

Specialty Focus

Medical Specialties

Primary Care

Documentation Requirements

Document family history, reason for testing, and any counseling provided.

Common Clinical Scenarios

Routine checkups where genetic testing is discussed, referrals to genetic specialists.

Billing Considerations

Consider social determinants such as patient education and access to genetic counseling.

Public Health

Documentation Requirements

Population-level data on genetic testing uptake and outcomes.

Common Clinical Scenarios

Community health initiatives promoting genetic testing awareness.

Billing Considerations

Focus on health disparities and access to genetic services.

Coding Guidelines

Inclusion Criteria

Use Z31.440 When
  • Z codes are used when a patient is not currently ill but is seeking care for preventive or screening purposes
  • 440 should be sequenced appropriately, often as a secondary diagnosis when a primary condition is present
  • Payer requirements may vary, so it is essential to verify coverage for genetic testing

Exclusion Criteria

Do NOT use Z31.440 When
No specific exclusions found.

Related CPT Codes

81200CPT Code

Cystic fibrosis carrier screening

Clinical Scenario

Used in conjunction with Z31.440 when testing for cystic fibrosis carrier status.

Documentation Requirements

Document the reason for testing and any counseling provided.

Specialty Considerations

Primary care providers should ensure comprehensive family history is included.

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 health risks.

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 health risks.

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 health risks.

Resources

Clinical References

  • •
    Genetic Testing Guidelines

Coding & Billing References

  • •
    Genetic Testing Guidelines

Frequently Asked Questions

What documentation is required for Z31.440?

Documentation must include the reason for testing, family history, and any counseling provided. Ensure that the medical record reflects the patient's understanding of the implications of genetic testing.