Z31.438 — Encounter for other genetic testing of female for procreative management
Is Z31.438 billable?
Yes — Z31.438 is billable for FY2027. Z31.438 is a valid, billable ICD-10-CM code at the highest level of specificity in its branch. Z31.438 may be submitted for encounters from October 1, 2026 through September 30, 2027.
Z31.438 at a glance
| Code | Z31.438 |
|---|---|
| Description | Encounter for other genetic testing of female for procreative management |
| Billable | Yes |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
What Medicare edits apply to Z31.438?
The Medicare Code Editor screens inpatient claims before they are grouped. These edits name Z31.438 directly.
CMS will reject this code as the principal diagnosis on an inpatient claim. It describes something other than the condition chiefly responsible for the admission.
Which MS-DRGs does Z31.438 group to?
Z31.438 sits in MDC 23 and helps define the logic of 1 MS-DRG (version 44, FY2027). Which one a stay actually groups to also depends on procedures and secondary diagnoses.
- 951Other Factors Influencing Health Statusmedical
How is Z31.438 listed in the Alphabetic Index?
These are the routes through the Alphabetic Index that lead to Z31.438. They show the wording a clinician may have documented, which often differs from the Tabular description.
- Test, tests, testing › genetic › procreative management NEC › female (for)
Excludes1 — never code together — inherited from Z31.4
The conditions below can never be reported together with Z31.438 on the same claim. An Excludes1 note means the two conditions cannot occur in the same patient, so reporting both is a coding error.
- postvasectomy sperm count (Z30.8)
Excludes1 — never code together — inherited from Z31.43
The conditions below can never be reported together with Z31.438 on the same claim. An Excludes1 note means the two conditions cannot occur in the same patient, so reporting both is a coding error.
- nonprocreative genetic testing (Z13.7-)
Use additional code — inherited from Z31.43
Report an additional code alongside Z31.438 to fully describe the condition. Z31.438 is sequenced first.
Excludes2 — not included here — inherited from Z31
The conditions below are not part of Z31.438, but a patient may have both at the same time. When documentation supports it, Z31.438 and the excluded code may both be reported.
How long has Z31.438 existed?
Z31.438 has been in ICD-10-CM since at least FY2016, the earliest fiscal year on record here.
Derived from the official order files for FY2016–FY2026. FY2017 and FY2020 publish no order file, so those years are not covered.