ICD-10-CM Code Z31.42

Aftercare following sterilization reversal

Version 2020 Billable Code Unacceptable Principal Diagnosis POA Exempt

Valid for Submission

Z31.42 is a billable code used to specify a medical diagnosis of aftercare following sterilization reversal. The code is valid for the year 2020 for the submission of HIPAA-covered transactions. The code is exempt from present on admission (POA) reporting for inpatient admissions to general acute care hospitals.

The code Z31.42 describes a circumstance which influences the patient's health status but not a current illness or injury. The code is unacceptable as a principal diagnosis.

ICD-10:Z31.42
Short Description:Aftercare following sterilization reversal
Long Description:Aftercare following sterilization reversal

Tabular List of Diseases and Injuries

The Tabular List of Diseases and Injuries is a list of ICD-10 codes, organized "head to toe" into chapters and sections with guidance for inclusions, exclusions, descriptions and more. The following references are applicable to the code Z31.42:

Inclusion Terms

Inclusion Terms
These terms are the conditions for which that code is to be used. The terms may be synonyms of the code title, or, in the case of "other specified" codes, the terms are a list of the various conditions assigned to that code. The inclusion terms are not necessarily exhaustive. Additional terms found only in the Alphabetic Index may also be assigned to a code.
  • Sperm count following sterilization reversal

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 Z31.42 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:

  • 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.

Present on Admission (POA)

Z31.42 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 Z31.42 to ICD-9

  • V26.22 - Sterilzation rev aftcare

Code Classification

  • Factors influencing health status and contact with health services (Z00–Z99)
    • Persons encountering health services in circumstances related to reproduction (Z30-Z39)
      • Encounter for procreative management (Z31)

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

Information for Patients


Tubal Ligation

Tubal ligation (getting your "tubes tied") is a type of surgery. It prevents a woman from getting pregnant. It is a permanent form of birth control, and is effective right away.

The surgery cuts, ties, or seals the fallopian tubes. This blocks the path between the ovaries and the uterus. The sperm cannot reach the egg to fertilize it, and the egg cannot reach the uterus. You get the surgery in a hospital or outpatient surgical center. It usually takes about 30 minutes. Almost all women go home the same day. They can return to most normal activities within a few days.

Tubal ligation can sometimes be reversed. The reversal is major surgery, and does not always work.


[Learn More]

Vasectomy

Vasectomy is a type of surgery that prevents a man from being able to get a woman pregnant. It is a permanent form of birth control.

A vasectomy works by cutting the tubes that carry the sperm out of the testicles. The surgery usually takes no more than 30 minutes. Most men go home the same day. In most cases, recovery takes less than a week. Having a vasectomy does not affect your sex life.

It takes about three months before it is effective. Your doctor will test your semen to make sure that there are no sperm in it.

Vasectomies can sometimes be reversed, but not always. Having a vasectomy does not protect against sexually transmitted diseases, such as HIV/AIDS. Men who have had a vasectomy should still practice safe sex to avoid STDs.

NIH: National Institute of Child Health and Human Development


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