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ICD-10 Guide
ICD-10 CodesZ31.7

Z31.7

Encounter for procreative management and counseling for gestational carrier

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

Code Description

ICD-10 Z31.7 is a billable code used to indicate a diagnosis of encounter for procreative management and counseling for gestational carrier.

Key Diagnostic Point:

Z31.7 is used to document encounters specifically related to procreative management and counseling for individuals or couples utilizing a gestational carrier. This code encompasses various factors influencing health status, including psychological readiness, social support systems, and financial considerations. It is essential for healthcare providers to assess the emotional and physical health of both the intended parents and the gestational carrier, ensuring that all parties are informed and prepared for the process. Preventive care may include counseling on reproductive health, mental health screenings, and discussions about the implications of using a gestational carrier. Social determinants of health, such as socioeconomic status, access to healthcare, and community support, play a crucial role in the success of this arrangement. Proper documentation is vital to capture the complexity of these encounters, ensuring that all relevant factors are addressed and that the care provided aligns with the needs of the individuals involved.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Need for comprehensive documentation of counseling sessions
  • Involvement of multiple healthcare providers (e.g., mental health, reproductive specialists)
  • Variability in state laws regarding gestational carriers
  • Potential for emotional and psychological factors impacting care

Audit Risk Factors

  • Inadequate documentation of counseling sessions
  • Failure to capture all relevant social determinants of health
  • Lack of clear linkage between the Z code and the primary diagnosis
  • Insufficient detail on the emotional and psychological assessments

Specialty Focus

Medical Specialties

Primary Care

Documentation Requirements

Documentation should include details of counseling sessions, assessments of mental health, and any referrals made to specialists.

Common Clinical Scenarios

Routine checkups for intended parents, mental health screenings, and follow-up visits post-counseling.

Billing Considerations

Consideration of social determinants such as financial stability and support systems is crucial.

Public Health

Documentation Requirements

Documentation should focus on population-level health impacts, including tracking outcomes related to gestational carriers.

Common Clinical Scenarios

Epidemiological studies on the health outcomes of gestational carriers and intended parents.

Billing Considerations

Monitoring and reporting on health disparities related to access to gestational carrier services.

Coding Guidelines

Inclusion Criteria

Use Z31.7 When
  • Z codes are used when a patient encounters healthcare services for reasons other than a current illness or injury
  • 7 should be sequenced appropriately, often following a primary diagnosis related to infertility or reproductive health
  • Payer requirements may vary, so it is essential to verify coverage for counseling services

Exclusion Criteria

Do NOT use Z31.7 When
No specific exclusions found.

Related CPT Codes

99401CPT Code

Preventive counseling visit

Clinical Scenario

Used during counseling sessions for intended parents regarding gestational carrier options.

Documentation Requirements

Documentation must include details of the counseling provided and any referrals made.

Specialty Considerations

Primary care providers should ensure comprehensive assessments are conducted.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for greater specificity in coding encounters related to reproductive health, including the use of gestational carriers. Z31.7 provides a clear framework for documenting these complex encounters.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for greater specificity in coding encounters related to reproductive health, including the use of gestational carriers. Z31.7 provides a clear framework for documenting these complex encounters.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for greater specificity in coding encounters related to reproductive health, including the use of gestational carriers. Z31.7 provides a clear framework for documenting these complex encounters.

Resources

Clinical References

  • •
    American Society for Reproductive Medicine Guidelines

Coding & Billing References

  • •
    American Society for Reproductive Medicine Guidelines

Frequently Asked Questions

What documentation is required for Z31.7?

Documentation must include details of the counseling sessions, assessments of mental health, and any referrals made to specialists. It should also capture social determinants of health impacting the encounter.