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ICD-10 Guide
ICD-10 CodesZ31.441

Z31.441

Encounter for testing of male partner of patient with recurrent pregnancy loss

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

Code Description

ICD-10 Z31.441 is a billable code used to indicate a diagnosis of encounter for testing of male partner of patient with recurrent pregnancy loss.

Key Diagnostic Point:

Z31.441 is utilized during encounters where a male partner is tested due to the female partner's history of recurrent pregnancy loss. This code reflects the importance of assessing male fertility factors, which can significantly influence reproductive outcomes. The clinical context involves understanding that recurrent pregnancy loss can stem from various causes, including genetic, anatomical, hormonal, and environmental factors. Social determinants of health, such as access to healthcare, socioeconomic status, and education, play a crucial role in the management of reproductive health. Preventive care in this scenario includes counseling on lifestyle modifications, genetic counseling, and screening for potential male infertility issues. Screening tests may include semen analysis and hormonal evaluations. Aftercare may involve follow-up consultations to discuss test results and potential treatment options, emphasizing the need for a holistic approach to reproductive health.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Need for comprehensive documentation of the patient's history of recurrent pregnancy loss.
  • Involvement of multiple healthcare providers (e.g., obstetricians, urologists).
  • Potential for overlapping diagnoses requiring careful differentiation.
  • Variability in payer requirements for coverage of testing.

Audit Risk Factors

  • Inadequate documentation of the reason for testing.
  • Failure to link the Z code to the primary diagnosis of recurrent pregnancy loss.
  • Lack of supporting evidence for the medical necessity of the tests performed.
  • Misclassification of the encounter type (preventive vs. diagnostic).

Specialty Focus

Medical Specialties

Primary Care

Documentation Requirements

Documentation should include a detailed history of the patient's reproductive health, any previous pregnancies, and the outcomes of those pregnancies.

Common Clinical Scenarios

Routine checkups for couples experiencing infertility, follow-up visits after testing, and discussions about lifestyle factors affecting fertility.

Billing Considerations

Consideration of social determinants such as access to care, mental health support, and education on reproductive health.

Public Health

Documentation Requirements

Documentation should focus on population health data, including statistics on recurrent pregnancy loss and male infertility rates.

Common Clinical Scenarios

Community health screenings, educational workshops on reproductive health, and outreach programs targeting at-risk populations.

Billing Considerations

Emphasis on tracking health disparities and ensuring equitable access to reproductive health services.

Coding Guidelines

Inclusion Criteria

Use Z31.441 When
  • Z codes are used when a patient encounters healthcare services for reasons other than a current illness or injury
  • 441 should be sequenced appropriately, typically following any primary diagnosis related to recurrent pregnancy loss
  • Payer requirements may vary, so it is essential to verify coverage for testing and counseling services

Exclusion Criteria

Do NOT use Z31.441 When
No specific exclusions found.

Related CPT Codes

89320CPT Code

Semen analysis

Clinical Scenario

Used when the male partner is tested for fertility issues following the female partner's recurrent pregnancy loss.

Documentation Requirements

Documentation must include the reason for the semen analysis and any relevant medical history.

Specialty Considerations

Primary care providers should ensure that referrals for testing are well-documented.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for greater specificity in coding, which is crucial for accurately capturing the complexities of reproductive health encounters, including those related to male partners.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for greater specificity in coding, which is crucial for accurately capturing the complexities of reproductive health encounters, including those related to male partners.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for greater specificity in coding, which is crucial for accurately capturing the complexities of reproductive health encounters, including those related to male partners.

Resources

Clinical References

  • •
    CDC Reproductive Health Guidelines

Coding & Billing References

  • •
    CDC Reproductive Health Guidelines

Frequently Asked Questions

What documentation is required for Z31.441?

Documentation must include the patient's history of recurrent pregnancy loss, the reason for testing the male partner, and any relevant medical evaluations or results.