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ICD-10 Guide
ICD-10 CodesZ31.83

Z31.83

Encounter for assisted reproductive fertility procedure cycle

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

Code Description

ICD-10 Z31.83 is a billable code used to indicate a diagnosis of encounter for assisted reproductive fertility procedure cycle.

Key Diagnostic Point:

Z31.83 is used to document encounters for patients undergoing assisted reproductive technology (ART) procedures, such as in vitro fertilization (IVF) or intrauterine insemination (IUI). These procedures are often influenced by various social determinants of health, including socioeconomic status, access to healthcare, and emotional support systems. Preventive care in this context may involve preconception counseling, fertility assessments, and screenings for underlying health issues that could affect fertility. Aftercare is crucial, as patients may require follow-up visits to monitor the outcomes of the procedures and manage any complications. Understanding the patient's social context, including their mental health and support networks, is essential for comprehensive care. Documentation must reflect the reason for the encounter, the specific procedures performed, and any relevant patient history to ensure accurate coding and billing.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Need for detailed documentation of the fertility procedure cycle.
  • Variability in procedures performed under ART.
  • Influence of social determinants on patient outcomes.
  • Potential for co-morbid conditions affecting fertility.

Audit Risk Factors

  • Inadequate documentation of the procedure performed.
  • Failure to capture relevant patient history.
  • Incorrect sequencing of codes related to fertility treatments.
  • Lack of clarity on the patient's social determinants of health.

Specialty Focus

Medical Specialties

Primary Care

Documentation Requirements

Documentation should include patient history, fertility assessments, and any preventive measures taken.

Common Clinical Scenarios

Routine checkups for patients undergoing fertility treatments, screenings for underlying health issues.

Billing Considerations

Consideration of mental health support and social factors affecting fertility.

Public Health

Documentation Requirements

Documentation should focus on population health data, access to fertility services, and outcomes tracking.

Common Clinical Scenarios

Epidemiological studies on fertility trends and access to ART services.

Billing Considerations

Monitoring health disparities related to fertility treatments.

Coding Guidelines

Inclusion Criteria

Use Z31.83 When
  • Z codes are used when a patient encounters health services for reasons other than a current illness or injury
  • 83 should be sequenced appropriately, often following a primary diagnosis related to infertility
  • Payer requirements may vary, so it's essential to verify coverage for ART procedures

Exclusion Criteria

Do NOT use Z31.83 When
No specific exclusions found.

Related CPT Codes

58970CPT Code

In vitro fertilization (IVF)

Clinical Scenario

Used in conjunction with Z31.83 for patients undergoing IVF.

Documentation Requirements

Documentation must include the IVF procedure details and patient consent.

Specialty Considerations

Primary care providers should ensure comprehensive patient history is documented.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for greater specificity in coding fertility procedures, improving the accuracy of health data and reimbursement processes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for greater specificity in coding fertility procedures, improving the accuracy of health data and reimbursement processes.

Reimbursement & Billing Impact

reimbursement processes.

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 Z31.83?

Documentation must include the specific ART procedure performed, patient history, and any relevant social determinants affecting fertility.