2025 ICD-10-CM code Z31.83
(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 assisted reproductive fertility procedure cycle.
Modifiers are not applicable to ICD-10 codes. Modifiers are used with CPT and HCPCS codes.
Medical necessity for Z31.83 is established by the presence of infertility diagnosed through appropriate testing and clinical evaluation.The use of ART procedures should align with accepted medical practice guidelines and be medically appropriate for the patient's specific circumstances.
The clinical responsibility for this code falls on the fertility specialist or reproductive endocrinologist managing the patient's care during the assisted reproductive technology (ART) cycle.This includes consultation, monitoring,and performance or supervision of procedures.
- Chapter 21: Factors influencing health status and contact with health services
- Z31.83 falls under the broader category of Z31 (Encounter for procreative management) and the even broader chapter of Z codes (Factors influencing health status and contact with health services).
In simple words: This code is used when someone goes to the doctor for a fertility treatment cycle, like in-vitro fertilization (IVF).
This ICD-10-CM code signifies an encounter for a cycle of assisted reproductive fertility procedures.It's used when a patient undergoes procedures such as in-vitro fertilization (IVF).Additional codes should be used to specify the type of infertility and any related procedures performed. This code is not appropriate as a principal diagnosis.
Example 1: A 38-year-old female patient presents for her first cycle of in-vitro fertilization (IVF).This includes egg retrieval, fertilization, embryo culture, and embryo transfer. Z31.83 is used to document this encounter., A 42-year-old female patient undergoes a second IVF cycle.The first cycle was unsuccessful, so this code is used again to document the encounter, alongside additional codes to describe the infertility and the specific procedures. , A couple presents for their first intrauterine insemination (IUI) cycle.While IUI is a different ART procedure than IVF, Z31.83 may be used to code for the encounter, along with appropriate additional codes such as codes for infertility type, as well as the procedure code(s) used for IUI.
Documentation should include a detailed history and physical exam,results of all diagnostic testing (hormone levels, ultrasound findings, semen analysis if applicable),a description of all procedures performed during the cycle, and any medications administered.
** Always confirm that the use of Z31.83 is clinically appropriate and accurately reflects the patient's encounter.Use additional codes as necessary to capture the complete clinical picture.Consult payer-specific guidelines for reimbursement policies.
- Revenue Code: Revenue codes will vary depending on the specific services rendered and the payer.Consult your payer's guidelines for appropriate revenue codes.
- RVU: RVUs are not applicable to ICD-10 codes. RVUs are associated with CPT and HCPCS codes, which represent procedures and services. The reimbursement for this code depends on the specific procedures and services performed, which would be reported using CPT and HCPCS codes.
- Global Days: Not applicable to ICD-10 codes. Global periods are associated with surgical procedures (CPT codes).
- Payment Status: Active
- Modifier TC rule: Not applicable to ICD-10 codes.
- Fee Schedule: Not applicable to ICD-10 codes.Reimbursement is determined by the procedures and services (CPT/HCPCS codes) performed, and payer specific guidelines.
- Specialties:Reproductive Endocrinology and Infertility, Obstetrics and Gynecology
- Place of Service:Office, Outpatient Hospital, Ambulatory Surgical Center, Fertility Clinic