2025 ICD-10-CM code Z43.0
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Encounter for attention to artificial openings - Encounters for other specific health care (Z40-Z53) Factors influencing health status and contact with health services (Z00-Z99) Feed
Encounter for attention to tracheostomy.
Modifiers are not applicable to ICD-10 codes.
Medical necessity for attention to a tracheostomy is established by the patient's need for ongoing care and maintenance of the airway.Documentation must justify the frequency and type of intervention provided.
The clinical responsibility depends on the specific services provided, but could include physicians, nurses, respiratory therapists, 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 a healthcare provider for a check-up or treatment related to their tracheostomy (a surgically created opening in the windpipe).
This ICD-10-CM code signifies an encounter for the purpose of providing care related to a tracheostomy.This includes procedures such as closure of artificial openings, passage of sounds or bougies, reforming artificial openings, removal of catheters, toilet or cleansing of artificial openings.It does not encompass complications of external stoma or fitting/adjustment of prosthetic devices.
Example 1: A patient with a tracheostomy visits for routine suctioning and tracheostomy care., A patient presents for the removal of a tracheostomy tube following successful weaning from ventilator support., A patient undergoes a procedure to replace a damaged tracheostomy tube.
Detailed documentation should include the reason for the encounter, specific procedures performed, assessment of the patient's respiratory status, any complications encountered, and the plan for ongoing care.
** While Z43.0 focuses on attention to the tracheostomy, other codes may be necessary to capture the underlying conditions necessitating the tracheostomy.This should be documented comprehensively.
- Revenue Code: Revenue codes will vary depending on the specific services provided and the payer.
- RVU: RVUs are not directly assigned to ICD-10 codes.Reimbursement depends on the procedures performed, which would have associated CPT codes with RVU values.
- Global Days: Not applicable to ICD-10 codes. Global days are relevant to 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.Reimbursement is determined by the procedures performed (CPT codes) and payer-specific fee schedules.
- Specialties:Pulmonology, Otolaryngology, Respiratory Therapy
- Place of Service:Office, Hospital Inpatient, Hospital Outpatient, Skilled Nursing Facility, Home Health