2025 ICD-10-CM code Z43.6
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Factors influencing health status and contact with health services - Encounters for other specific health care (Z40-Z53) Factors influencing health status and contact with health services (Z00-Z99) Feed
Encounter for attention to other artificial openings of the urinary tract.
ICD-10 codes do not utilize modifiers. Modifiers are appended to CPT or HCPCS codes.
Medical necessity is established by the need for care and maintenance of the artificial opening to ensure proper urinary function and prevent complications.Documentation supporting the clinical need for the service is crucial for reimbursement.
The clinical responsibility depends on the specific services rendered.It could involve urologists, nurses, or other healthcare professionals.
- Factors influencing health status and contact with health services (Z00-Z99)
- Z43 Encounter for attention to artificial openings
In simple words: This code is used when someone goes to the doctor for checkups or treatment related to a surgically created opening in their urinary system (like a nephrostomy, ureterostomy, or urethrostomy),excluding the initial surgery or fitting of devices.
This ICD-10-CM code signifies an encounter for medical attention focused on other artificial openings within the urinary tract.This encompasses various procedures and examinations related to these openings, excluding complications or fitting/adjustment of devices.Specific examples include closure of artificial openings, passage of instruments, reforming openings, catheter removal, and cleaning or toileting of the openings.The code is used when the primary reason for the encounter is the management or care of the artificial opening itself.
Example 1: A patient with a nephrostomy tube undergoes a routine check-up and tube irrigation., A patient presents for the removal of a ureterostomy catheter following a urinary tract infection., A patient requires surgical closure of a urethrostomy due to complications.
Documentation should include the type of artificial opening, reason for the encounter (e.g., routine maintenance, complication management), procedures performed, and assessment of the patient's condition.
** This code should not be used for complications related to the artificial opening, fitting of devices, or follow-up examinations after treatment. Those should be coded separately.
- Revenue Code: Revenue codes will vary depending on the specific services rendered and the payer.
- RVU: RVUs are not directly associated with ICD-10 codes.Reimbursement is determined by the procedures performed, using CPT or HCPCS codes, which have associated RVUs.
- Global Days: Not applicable to ICD-10 codes. Global periods are associated with surgical procedures coded with CPT codes.
- Payment Status: Active
- Modifier TC rule: Not applicable to ICD-10 codes.
- Fee Schedule: Not applicable to ICD-10 codes.
- Specialties:Urology
- Place of Service:Office, Hospital (Inpatient or Outpatient), Ambulatory Surgical Center, other settings as appropriate to the care provided.