2025 ICD-10-CM code Z31.81
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Factors influencing health status and contact with health services - Persons encountering health services in circumstances related to reproduction Chapter 21: Factors Influencing Health Status and Contact with Health Services Feed
Encounter for male factor infertility in a female patient.
Modifiers are not applicable to ICD-10 codes.
Medical necessity for this code is established by the patient's presentation with infertility concerns specifically related to the male partner's reproductive health. Documentation should clearly show that the focus of the visit was to address this issue, including relevant clinical information and the decision-making process leading to the visit.
The clinical responsibility depends on the specific services provided but could include a consultation with a reproductive endocrinologist, urologist, or other healthcare professional involved in fertility management.The physician would document the reason for the encounter, relevant findings, and any recommended treatment or further investigations.
- Chapter 21: Factors Influencing Health Status and Contact with Health Services
- Z30-Z39: Persons encountering health services in circumstances related to reproduction
In simple words: This code is used when a woman goes to the doctor because her partner has problems that are preventing them from having a baby.The visit is specifically about the man's fertility issues affecting the couple's ability to conceive.
This ICD-10-CM code signifies an encounter for a female patient where the reason for the visit is related to male factor infertility.This code is used when the female patient is seeking medical attention or consultation due to infertility issues stemming from the male partner's reproductive health.It does not indicate a diagnosis of infertility in the female patient herself, but rather that the male partner's infertility is the focus of the encounter.
Example 1: A female patient presents with her male partner for a consultation regarding infertility.The male partner has been diagnosed with oligospermia. The physician documents the visit using Z31.81, along with codes representing the male partner's condition (e.g., N46.11) and any tests performed. , A female patient seeks advice on options for conceiving given her husband's low sperm count. The visit is focused on discussing treatment choices for male factor infertility, such as in-vitro fertilization (IVF).The physician uses Z31.81 to document the reason for the encounter and may also use codes for any tests or procedures performed., A female patient is undergoing infertility testing, and the results point towards male factor infertility as the primary cause. She visits her physician to review the results and discuss further treatment. The physician utilizes Z31.81 to capture the reason for this follow-up visit relating to male factor infertility.
Complete medical record documentation should include the patient's reason for the visit, the history of infertility issues, relevant investigations (semen analysis, hormonal studies, etc.), and any plan of action decided with the patient.The documentation should clearly indicate the focus of the visit is on male factor infertility affecting the female patient's ability to conceive.
** This code should only be used as the principal diagnosis if no other diagnosis is present.If other conditions are present, this code should be used as a secondary diagnosis. This code should not be used if the primary diagnosis relates to a female infertility condition.
- Revenue Code: Revenue codes will vary depending on the specific services provided during the encounter.
- RVU: RVUs are not applicable to ICD-10 codes.RVUs are associated with procedural codes (CPT, HCPCS) that describe specific services and procedures, which would be reported separately along with Z31.81 if any were performed.
- Global Days: Not applicable to ICD-10 codes.
- Payment Status: Active
- Modifier TC rule: Not applicable to ICD-10 codes.
- Fee Schedule: Not applicable to ICD-10 codes.
- Specialties:Reproductive Endocrinology and Infertility, Obstetrics and Gynecology, Urology
- Place of Service:Office, Outpatient Clinic, Hospital