2024 ICD-10-CM Diagnosis Code Z40.03
Encounter for prophylactic removal of fallopian tube(s)
- ICD-10-CM Code:
- Z40.03
- ICD-10 Code for:
- Encounter for prophylactic removal of fallopian tube(s)
- Is Billable?
- Yes - Valid for Submission
- Code Navigator:
Z40.03 is a billable diagnosis code used to specify a medical diagnosis of encounter for prophylactic removal of fallopian tube(s). The code is valid during the current fiscal year for the submission of HIPAA-covered transactions from October 01, 2023 through September 30, 2024. The code is exempt from present on admission (POA) reporting for inpatient admissions to general acute care hospitals.
This code is applicable to female patients only. It is clinically and virtually impossible to use this code on a non-female patient.
Clinical Classification
Clinical Category is Encounter for prophylactic or other procedures
- CCSR Category Code: FAC004
- Inpatient Default CCSR: Y - Yes, default inpatient assignment for principal diagnosis or first-listed diagnosis.
- Outpatient Default CCSR: Y - Yes, default outpatient assignment for principal diagnosis or first-listed diagnosis.
Index to Diseases and Injuries References
The following annotation back-references for this diagnosis code are found in the injuries and diseases index. The Index to Diseases and Injuries is an alphabetical listing of medical terms, with each term mapped to one or more ICD-10-CM code(s).
- - Admission (for) - See Also: Encounter (for);
- - prophylactic (measure) - See Also: Encounter, prophylactic measures;
- - organ removal - Z40.00
- - fallopian tube (s) - Z40.03
- - organ removal - Z40.00
- - prophylactic (measure) - See Also: Encounter, prophylactic measures;
- - Prophylactic
- - organ removal (for neoplasia management) - Z40.00
- - fallopian tube (s) - Z40.03
- - organ removal (for neoplasia management) - Z40.00
Code Edits
The Medicare Code Editor (MCE) detects and reports errors in the coding of claims data. The following ICD-10-CM Code Edits are applicable to this code:
- Diagnoses for females only - The Medicare Code Editor detects inconsistencies between a patient’s sex and any diagnosis on the patient’s record, these edits apply to FEMALES only .
Present on Admission (POA)
Z40.03 is exempt from POA reporting - The Present on Admission (POA) indicator is used for diagnosis codes included in claims involving inpatient admissions to general acute care hospitals. POA indicators must be reported to CMS on each claim to facilitate the grouping of diagnoses codes into the proper Diagnostic Related Groups (DRG). CMS publishes a listing of specific diagnosis codes that are exempt from the POA reporting requirement. Review other POA exempt codes here.
CMS POA Indicator Options and Definitions
POA Indicator | Reason for Code | CMS will pay the CC/MCC DRG? |
---|---|---|
Y | Diagnosis was present at time of inpatient admission. | YES |
N | Diagnosis was not present at time of inpatient admission. | NO |
U | Documentation insufficient to determine if the condition was present at the time of inpatient admission. | NO |
W | Clinically undetermined - unable to clinically determine whether the condition was present at the time of inpatient admission. | YES |
1 | Unreported/Not used - Exempt from POA reporting. | NO |
Replacement Code
Z4003 replaces the following previously assigned ICD-10-CM code(s):
- Z40.09 - Encounter for prophylactic removal of other organ
Convert Z40.03 to ICD-9-CM
- ICD-9-CM Code: V50.49 - Prphylct orgn rmvl other
Approximate Flag - The approximate mapping means there is not an exact match between the ICD-10 and ICD-9 codes and the mapped code is not a precise representation of the original code.
Code History
- FY 2024 - No Change, effective from 10/1/2023 through 9/30/2024
- FY 2023 - No Change, effective from 10/1/2022 through 9/30/2023
- FY 2022 - No Change, effective from 10/1/2021 through 9/30/2022
- FY 2021 - No Change, effective from 10/1/2020 through 9/30/2021
- FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020
- FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
- FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018