ICD-10 Diagnosis Code Z31.438

Encounter for oth genetic testing of female for pro mgmt

Diagnosis Code Z31.438

ICD-10: Z31.438
Short Description: Encounter for oth genetic testing of female for pro mgmt
Long Description: Encounter for other genetic testing of female for procreative management
This is the 2019 version of the ICD-10-CM diagnosis code Z31.438

Valid for Submission
The code Z31.438 is valid for submission for HIPAA-covered transactions.

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)

Information for Medical Professionals


Code Edits
The following edits are applicable to this code:
Diagnoses for females only - Diagnoses for 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.

Convert to ICD-9
  • V26.32 - Female genetic test NEC (Approximate Flag)

Present on Admission (POA)
The code Z31.438 is exempt from POA reporting.

Information for Patients


Genetic Testing

Genetic tests are tests on blood and other tissue to find genetic disorders. Over 2000 tests are available. Doctors use genetic tests for several reasons. These include

  • Finding genetic diseases in unborn babies
  • Finding out if people carry a gene for a disease and might pass it on to their children
  • Screening embryos for disease
  • Testing for genetic diseases in adults before they cause symptoms
  • Making a diagnosis in a person who has disease symptoms
  • Figuring out the type or dose of a medicine that is best for a certain person

People have many different reasons for being tested or not being tested. For some, it is important to know whether a disease can be prevented or treated if a test is positive. In some cases, there is no treatment. But test results might help a person make life decisions, such as family planning or insurance coverage. A genetic counselor can provide information about the pros and cons of testing.

NIH: National Human Genome Research Institute

  • BRCA1 and BRCA2 gene testing (Medical Encyclopedia)
  • Genetic testing and your cancer risk (Medical Encyclopedia)
  • Genetic Testing: What It Means for Your Health and Your Family's Health - NIH (National Institutes of Health)

[Read More]

ICD-10 Footnotes

General Equivalence Map Definitions
The ICD-10 and ICD-9 GEMs are used to facilitate linking between the diagnosis codes in ICD-9-CM and the new ICD-10-CM code set. The GEMs are the raw material from which providers, health information vendors and payers can derive specific applied mappings to meet their needs.

  • Approximate Flag - The approximate flag is on, indicating that the relationship between the code in the source system and the code in the target system is an approximate equivalent.
  • No Map Flag - The no map flag indicates that a code in the source system is not linked to any code in the target system.
  • Combination Flag - The combination flag indicates that more than one code in the target system is required to satisfy the full equivalent meaning of a code in the source system.

Present on Admission
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.

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