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v1.0.0
ICD-10 Guide
ICD-10 CodesZ31.62

Z31.62

Encounter for fertility preservation counseling

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

Code Description

ICD-10 Z31.62 is a billable code used to indicate a diagnosis of encounter for fertility preservation counseling.

Key Diagnostic Point:

Z31.62 is used to document encounters specifically for fertility preservation counseling, which is crucial for individuals facing potential infertility due to medical treatments (e.g., chemotherapy, radiation) or other health conditions. This counseling aims to inform patients about options such as sperm banking, egg freezing, and embryo preservation, ensuring they are aware of their reproductive choices. Factors influencing health status include age, medical history, and social determinants such as socioeconomic status, access to healthcare, and support systems. Preventive care in this context involves proactive discussions about fertility preservation before initiating treatments that may impair reproductive capabilities. Screening for potential fertility issues may also be part of the counseling process, particularly for patients with known risk factors. Aftercare may involve follow-up consultations to discuss the outcomes of preservation efforts and future reproductive planning.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Need for thorough documentation of patient history and treatment plans
  • Variability in patient understanding and decision-making regarding fertility options
  • Potential for multiple encounters related to fertility preservation
  • Integration of social determinants of health into patient assessments

Audit Risk Factors

  • Inadequate documentation of the medical necessity for counseling
  • Failure to capture all relevant patient history and treatment plans
  • Misalignment between the counseling provided and the code billed
  • Lack of follow-up documentation to support ongoing care

Specialty Focus

Medical Specialties

Primary Care

Documentation Requirements

Document patient history, risk factors, and counseling details. Include discussions about treatment options and patient preferences.

Common Clinical Scenarios

Routine checkups where fertility preservation is discussed, especially for patients undergoing treatments that may affect fertility.

Billing Considerations

Consider social determinants such as access to fertility services, insurance coverage, and patient support systems.

Public Health

Documentation Requirements

Document population-level data on fertility preservation needs and access to services. Include demographic information for health status tracking.

Common Clinical Scenarios

Epidemiological studies assessing the impact of cancer treatments on fertility in various populations.

Billing Considerations

Focus on health equity and access to fertility preservation services across different communities.

Coding Guidelines

Inclusion Criteria

Use Z31.62 When
  • Z codes are used to indicate encounters for reasons other than illness or injury
  • When coding Z31
  • 62, ensure it is the primary reason for the visit
  • Sequence Z codes appropriately, often following the primary diagnosis code related to the patient's medical condition
  • Payer requirements may vary, so verify coverage for fertility counseling services

Exclusion Criteria

Do NOT use Z31.62 When
No specific exclusions found.

Related CPT Codes

99213CPT Code

Established patient office visit, Level 3

Clinical Scenario

Used during a counseling session for fertility preservation.

Documentation Requirements

Document the reason for the visit, counseling provided, and any decisions made.

Specialty Considerations

Primary care providers should ensure comprehensive documentation of patient discussions.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has increased specificity for Z codes, allowing for better tracking of fertility preservation counseling encounters and improving the understanding of patient needs in this area.

ICD-9 vs ICD-10

The transition to ICD-10 has increased specificity for Z codes, allowing for better tracking of fertility preservation counseling encounters and improving the understanding of patient needs in this area.

Reimbursement & Billing Impact

The transition to ICD-10 has increased specificity for Z codes, allowing for better tracking of fertility preservation counseling encounters and improving the understanding of patient needs in this area.

Resources

Clinical References

  • •
    ASCO Guidelines on Fertility Preservation

Coding & Billing References

  • •
    ASCO Guidelines on Fertility Preservation

Frequently Asked Questions

What documentation is required for Z31.62?

Documentation must include the patient's medical history, the reason for the counseling, options discussed, and any decisions made regarding fertility preservation. It should also reflect the patient's understanding and consent.