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v1.0.0
ICD-10 Guide
ICD-10 CodesZ31

Z31

Encounter for procreative management

BILLABLE STATUSNo
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/05/2025

Code Description

ICD-10 Z31 is a used to indicate a diagnosis of encounter for procreative management.

Key Diagnostic Point:

The ICD-10 Level 1 Category code Z31 is designated for encounters related to procreative management. This category encompasses a variety of situations where individuals or couples seek assistance with reproductive health, including fertility evaluations, counseling regarding reproductive options, and management of infertility. It is crucial for healthcare providers to accurately document these encounters to ensure appropriate care and follow-up for patients seeking to conceive or manage reproductive health issues. Conditions covered under this category may include infertility assessments, preconception counseling, and other related reproductive health services.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of conditions covered
  • Need for detailed documentation
  • Potential for multiple encounters

Audit Risk Factors

  • Inadequate documentation of patient history
  • Misuse of codes for non-reproductive encounters
  • Failure to follow up on patient outcomes

Specialty Focus

Medical Specialties

Obstetrics and Gynecology

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Reproductive Endocrinology

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Related Codes

Child Codes

25 codes
Z31.0
Encounter for reversal of previous sterilization
Z31.4
Encounter for procreative investigation and testing
Z31.41
Encounter for fertility testing
Z31.42
Aftercare following sterilization reversal
Z31.43
Encounter for genetic testing of female for procreative management
Z31.430
Encounter of female for testing for genetic disease carrier status for procreative management
Z31.438
Encounter for other genetic testing of female for procreative management
Z31.44
Encounter for genetic testing of male for procreative management
Z31.440
Encounter of male for testing for genetic disease carrier status for procreative management
Z31.441
Encounter for testing of male partner of patient with recurrent pregnancy loss
Z31.448
Encounter for other genetic testing of male for procreative management
Z31.49
Encounter for other procreative investigation and testing
Z31.5
Encounter for procreative genetic counseling
Z31.6
Encounter for general counseling and advice on procreation
Z31.61
Procreative counseling and advice using natural family planning
Z31.62
Encounter for fertility preservation counseling
Z31.69
Encounter for other general counseling and advice on procreation
Z31.7
Encounter for procreative management and counseling for gestational carrier
Z31.8
Encounter for other procreative management
Z31.81
Encounter for male factor infertility in female patient
Z31.82
Encounter for Rh incompatibility status
Z31.83
Encounter for assisted reproductive fertility procedure cycle
Z31.84
Encounter for fertility preservation procedure
Z31.89
Encounter for other procreative management
Z31.9
Encounter for procreative management, unspecified

Related CPT Codes

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The clinical and administrative impact of the Z31 code category is significant, as it plays a crucial role in tracking reproductive health trends and outcomes. Accurate coding can improve quality measures related to fertility treatments and reproductive health services, ultimately contributing to better population health management. Additionally, as healthcare trends increasingly focus on personalized medicine and reproductive health, the data collected through Z31 encounters can inform public health initiatives and resource allocation for reproductive health services.

ICD-9 vs ICD-10

The clinical and administrative impact of the Z31 code category is significant, as it plays a crucial role in tracking reproductive health trends and outcomes. Accurate coding can improve quality measures related to fertility treatments and reproductive health services, ultimately contributing to better population health management. Additionally, as healthcare trends increasingly focus on personalized medicine and reproductive health, the data collected through Z31 encounters can inform public health initiatives and resource allocation for reproductive health services.

Reimbursement & Billing Impact

reimbursement. Providers should ensure that all services rendered during the encounter are clearly documented, including any counseling or assessments performed. It is also important to check for any payer-specific requirements, as some insurers may have additional documentation needs or restrictions on the use of Z31 codes. Proper coding can facilitate smoother claims processing and reduce the likelihood of denials or audits.

Resources

Clinical References

  • •
    Official ICD-10 Guidelines for Z31

Coding & Billing References

  • •
    Official ICD-10 Guidelines for Z31

Frequently Asked Questions

What conditions are included in Z31?

Z31 includes conditions related to procreative management such as infertility assessments, counseling for reproductive health, and preconception consultations.

When should I use Z31 codes?

Z31 codes should be used when a patient is seeking assistance with reproductive health management, including fertility evaluations or counseling regarding conception.

What documentation is required for Z31?

Documentation should include detailed patient history, reasons for the encounter, any assessments performed, and plans for further management or treatment.