ICD-10-CM Code Z03.73

Encounter for suspected fetal anomaly ruled out

Version 2020 Billable Code Maternity Diagnoses Diagnoses For Females Only Unacceptable Principal Diagnosis POA Exempt

Valid for Submission

Z03.73 is a billable code used to specify a medical diagnosis of encounter for suspected fetal anomaly ruled out. The code is valid for the year 2020 for the submission of HIPAA-covered transactions. The ICD-10-CM code Z03.73 might also be used to specify conditions or terms like fetal hydrocephalus suspected or fetal spina bifida suspected or suspect trisomy 21 fetus or suspected chromosome abnormality or suspected downs syndrome. The code is exempt from present on admission (POA) reporting for inpatient admissions to general acute care hospitals.

The code Z03.73 is applicable to female patients aged 12 through 55 years inclusive. It is clinically and virtually impossible to use this code on a non-female patient outside the stated age range.

ICD-10:Z03.73
Short Description:Encounter for suspected fetal anomaly ruled out
Long Description:Encounter for suspected fetal anomaly ruled out

Index to Diseases and Injuries

The Index to Diseases and Injuries is an alphabetical listing of medical terms, with each term mapped to one or more ICD-10 code(s). The following references for the code Z03.73 are found in the index:


Code Edits

The Medicare Code Editor (MCE) detects and reports errors in the coding of claims data. The following ICD-10 Code Edits are applicable to this code:

  • Maternity diagnoses - Maternity. Age range is 12–55 years inclusive (e.g., diabetes in pregnancy, antepartum pulmonary complication).
  • Diagnoses for females only - Medicare Code Editor detects inconsistencies between a patient’s sex and any diagnosis on the patient’s record, this code applies to FEMALES only .
  • Unacceptable principal diagnosis - There are selected codes that describe a circumstance which influences an individual’s health status but not a current illness or injury, or codes that are not specific manifestations but may be due to an underlying cause. These codes are considered unacceptable as a principal diagnosis.

Synonyms

The following clinical terms are approximate synonyms or lay terms that might be used to identify the correct diagnosis code:

  • Fetal hydrocephalus suspected
  • Fetal spina bifida suspected
  • Suspect trisomy 21 fetus
  • Suspected chromosome abnormality
  • Suspected Downs syndrome

Present on Admission (POA)

Z03.73 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 CodePOA Reason for CodeCMS will pay the CC/MCC DRG?
YDiagnosis was present at time of inpatient admission.YES
NDiagnosis was not present at time of inpatient admission.NO
UDocumentation insufficient to determine if the condition was present at the time of inpatient admission.NO
WClinically undetermined - unable to clinically determine whether the condition was present at the time of inpatient admission.YES
1Unreported/Not used - Exempt from POA reporting. NO

Convert Z03.73 to ICD-9

  • V89.03 - Sus fetal anomaly nt fnd

Code Classification

  • Factors influencing health status and contact with health services (Z00–Z99)
    • Persons encountering health services for examinations (Z00-Z13)
      • Encntr for medical obs for susp diseases and cond ruled out (Z03)

Code History

  • FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016
    (First year ICD-10-CM implemented into the HIPAA code set)
  • FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
  • FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
  • FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
  • FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020