2025 ICD-10-CM code Z43.1
(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 Chapter 21: Factors Influencing Health Status and Contact with Health Services Feed
Encounter for attention to a gastrostomy.
Modifiers may be applicable depending on the specific procedure performed; consult official coding guidelines.
Medical necessity is established by the need for assessment, maintenance, or repair of the gastrostomy tube to ensure adequate nutrition or drainage.
The clinical responsibility depends on the specific procedure performed. It could involve a gastroenterologist, surgeon, or other relevant specialist.
- Chapter 21: Factors Influencing Health Status and Contact with Health Services
- Z40-Z53 (Encounters for other specific health care)
In simple words: This code is used when someone goes to the doctor for a check-up or procedure related to their feeding tube (gastrostomy).
This ICD-10-CM code signifies an encounter for medical attention related to a gastrostomy.This could include procedures such as closure, passage of sounds or bougies, reformation, catheter removal, cleansing, or toileting of the gastrostomy.It excludes complications of the external stoma and fitting/adjustment of prosthetic devices.
Example 1: A patient with a gastrostomy tube requires a tube change.The physician performs the procedure and the encounter is coded with Z43.1 and a corresponding procedural code., A patient presents for routine cleaning and maintenance of their gastrostomy tube. The encounter is coded with Z43.1 and a corresponding procedural code (if applicable)., A patient experiences complications from their gastrostomy tube, such as infection or leakage. The physician addresses the issue, and the encounter would be coded with Z43.1 along with codes for the specific complication and any procedures performed.
Documentation should include the reason for the encounter, a description of any procedures performed, and the patient's overall condition.
** Always ensure that a procedure code is included if a procedure was performed during the encounter.The use of this code requires proper documentation outlining the reason for the visit and any procedures completed.
- Payment Status: Active
- Modifier TC rule: Not applicable to this code; it describes the encounter reason, not a specific procedure with technical components.
- Specialties:Gastroenterology, Surgery, General Practice
- Place of Service:Office, Outpatient Hospital, Inpatient Hospital, Skilled Nursing Facility, Home Health