2025 ICD-10-CM code Z31.5
Encounter for procreative genetic counseling.
Medical necessity is established when the patient has a known or suspected risk factor for genetic disorders related to reproduction.
The healthcare provider is responsible for providing genetic counseling related to procreation, assessing risks, and discussing available options with the patient.
- Chapter 21: Factors influencing health status and contact with health services (Z00-Z99)
- Persons encountering health services in circumstances related to reproduction (Z30-Z3A)
In simple words: This code is used when someone visits a healthcare professional for genetic counseling related to reproduction.
This code is used for encounters with health services for genetic counseling related to procreation.
Example 1: A couple planning to conceive seeks genetic counseling to assess their risk of having a child with a genetic disorder., A woman with a family history of cystic fibrosis seeks genetic counseling before undergoing in vitro fertilization., An individual considering using donor sperm or eggs seeks genetic counseling to understand potential implications for their future offspring.
Documentation should include the reason for the encounter, family history, patient's concerns, and any recommendations made.
** Z codes represent reasons for encounters. The code is exempt from the Present on Admission (POA) reporting requirement.
- Payment Status: Active
- Specialties:Genetics, Obstetrics and Gynecology, Reproductive Endocrinology, Infertility
- Place of Service:Office, Outpatient Hospital, Telehealth Provided in Patient’s Home, Telehealth Provided Other than in Patient’s Home