2025 ICD-10-CM code Z31.4
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Factors influencing health status and contact with health services - Encounter for procreative management Factors influencing health status and contact with health services (Z00-Z99) Feed
Encounter for procreative investigation and testing.
Modifiers may be applicable depending on the specific procedures performed.Consult current coding guidelines for specific modifier application.
Medical necessity is established by the presence of infertility, desire for sterilization reversal, or the presence of a family history suggestive of genetic risk.
The clinical responsibility falls on the physician or healthcare provider performing and interpreting the procreative investigations and tests. This may involve ordering and reviewing lab results, counseling patients, and coordinating with specialists as needed.
- Factors influencing health status and contact with health services (Z00-Z99)
- Z30-Z39: Persons encountering health services in circumstances related to reproduction; Z31: Encounters for procreative management
In simple words: This code is used when someone goes to a doctor for tests and checks to help them get pregnant.This might include tests of the fallopian tubes, sperm counts, or genetic testing.
This code signifies an encounter for investigations and tests related to procreation.It includes procedures like fertility testing (e.g., fallopian tube patency testing, sperm count for fertility testing), genetic testing for procreative management (female or male), and aftercare following sterilization reversal.It excludes post-vasectomy sperm counts (Z30.8), complications of artificial fertilization (N98.-), female infertility (N97.-), male infertility (N46.-), and non-procreative genetic testing (Z13.7-).
Example 1: A couple experiencing infertility undergoes a series of tests including semen analysis, ovulation monitoring, and hysterosalpingography., A woman considering a sterilization reversal seeks consultation and testing to evaluate the feasibility of the procedure and potential success rates., A couple undergoes genetic carrier screening to assess the risk of transmitting genetic disorders to their offspring.
Detailed medical history, results of all relevant investigations (semen analysis, hormonal profiles, ultrasound reports, genetic test results), physician's notes documenting the consultations and interpretations of the findings.
** This code is a Z code, indicating a reason for encounter rather than a disease.It should be used when the primary reason for the visit is procreative investigation and testing, even if other diagnoses are present.
- Payment Status: Active
- Specialties:Obstetrics and Gynecology, Reproductive Endocrinology and Infertility, Urology, Genetics
- Place of Service:Office, Outpatient Hospital, Fertility Clinic