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ICD-10 Guide
ICD-10 CodesZ31.448

Z31.448

Encounter for other genetic testing of male for procreative management

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

Code Description

ICD-10 Z31.448 is a billable code used to indicate a diagnosis of encounter for other genetic testing of male for procreative management.

Key Diagnostic Point:

Z31.448 is used to document encounters for genetic testing in males aimed at procreative management. This testing may include assessments for hereditary conditions that could affect offspring, such as chromosomal abnormalities or genetic predispositions to certain diseases. The decision to pursue genetic testing can be influenced by various social determinants of health, including family history, socioeconomic status, and access to healthcare services. Preventive care is emphasized, as identifying genetic risks can lead to informed reproductive choices and management strategies. Screening for genetic conditions is crucial for couples planning to conceive, as it can guide interventions and counseling. Aftercare may involve follow-up consultations to discuss test results and implications for family planning. Proper documentation is essential to ensure accurate coding and reimbursement, as well as to facilitate continuity of care.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Need for comprehensive family history documentation
  • Variability in genetic testing protocols and interpretations
  • Potential for multiple genetic tests to be performed
  • Integration of social determinants of health into patient assessment

Audit Risk Factors

  • Inadequate documentation of medical necessity for genetic testing
  • Failure to link genetic testing to specific procreative management decisions
  • Misclassification of the type of genetic testing performed
  • Lack of follow-up documentation post-testing

Specialty Focus

Medical Specialties

Primary Care

Documentation Requirements

Documentation should include patient history, reason for testing, and any counseling provided regarding results and implications.

Common Clinical Scenarios

Routine checkups where genetic testing is discussed, preconception counseling sessions, and follow-up visits after testing.

Billing Considerations

Consideration of social determinants such as access to genetic counseling services and the patient's understanding of genetic risks.

Public Health

Documentation Requirements

Documentation should focus on population-level data collection, including demographics and health outcomes related to genetic testing.

Common Clinical Scenarios

Epidemiological studies assessing the prevalence of genetic conditions in specific populations and preventive health initiatives.

Billing Considerations

Tracking health disparities and access to genetic testing services among different demographic groups.

Coding Guidelines

Inclusion Criteria

Use Z31.448 When
  • Z codes are used when a patient encounters health services for reasons other than a current illness or injury
  • When coding Z31
  • 448, it should be sequenced appropriately based on the primary reason for the encounter
  • Payer requirements may vary, so it is essential to verify coverage for genetic testing and associated counseling

Exclusion Criteria

Do NOT use Z31.448 When
No specific exclusions found.

Related CPT Codes

81220CPT Code

Cystic fibrosis gene analysis

Clinical Scenario

Used in conjunction with Z31.448 when testing for cystic fibrosis risk.

Documentation Requirements

Documentation must include the reason for testing and any relevant family history.

Specialty Considerations

Primary care providers should ensure they understand the implications of the test results for patient counseling.

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, enabling better tracking of health outcomes and resource allocation.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for greater specificity in coding genetic testing encounters, enabling better tracking of health outcomes and resource allocation.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for greater specificity in coding genetic testing encounters, enabling better tracking of health outcomes and resource allocation.

Resources

Clinical References

  • •
    Genetic Testing Guidelines

Coding & Billing References

  • •
    Genetic Testing Guidelines

Frequently Asked Questions

What documentation is required for Z31.448?

Documentation must include the reason for the genetic testing, any relevant family history, and details of counseling provided regarding the implications of the results for procreative management.