2025 ICD-10-CM code Z43.8
Encounter for attention to other artificial openings. This code is used for aftercare, prophylactic care, care to consolidate treatment, or to deal with a residual state.
Medical necessity for the encounter should be clearly documented, indicating the reason for the visit and the specific services provided related to the artificial opening. Z codes alone do not justify medical necessity for procedures. The medical record should clearly document the medical reason for the service/procedure.
The physician or other healthcare professional is responsible for providing the necessary care and attention to the artificial opening, which may include cleaning, dressing changes, or other procedures as needed.
- Chapter 21: Factors influencing health status and contact with health services (Z00-Z99)
- Encounters for other specific health care (Z40-Z53)
In simple words: This code is used when a person visits a healthcare provider for care related to an artificial opening, such as a tracheostomy, gastrostomy, ileostomy, colostomy, cystostomy, or other artificial openings.
Encounter for attention to other artificial openings.This includes closure, passage of instruments, reforming, catheter removal, and cleansing of artificial openings, excluding complications and fitting/adjustments of prosthetic devices.
Example 1: A patient with a nephrostomy tube (an artificial opening in the kidney) presents for a routine tube change and site care., A patient with a mucus fistula (an abnormal connection between two organs or between an organ and the skin) requires ongoing wound care and dressing changes., A patient with a jejunostomy tube (an artificial opening into the jejunum, part of the small intestine) comes in for adjustments to the tube placement and feeding schedule.
Documentation should specify the type of artificial opening, the specific care provided, and any associated complications or issues.
** This code is exempt from the Present On Admission (POA) reporting requirement.
- Specialties:General surgery, Urology, Gastroenterology, Wound care specialists
- Place of Service:Inpatient Hospital, On Campus-Outpatient Hospital, Off Campus-Outpatient Hospital, Office, Home, Skilled Nursing Facility, Nursing Facility