ICD-10 Code Z31.5

Encounter for procreative genetic counseling

Version 2019 Replaced Code Billable Code Unacceptable Principal Diagnosis POA Exempt
ICD-10:Z31.5
Short Description:Encounter for procreative genetic counseling
Long Description:Encounter for procreative genetic counseling

Valid for Submission

ICD-10 Z31.5 is a billable code used to specify a medical diagnosis of encounter for procreative genetic counseling. The code is valid for the year 2019 for the submission of HIPAA-covered transactions.

Deleted Code

This code was deleted in the 2019 ICD-10 code set with the code(s) listed below. The National Center for Health Statistics (NCHS) has published an update to the ICD-10-CM diagnosis codes which became effective October 1, 2018. This code was replaced for the FY 2019 (October 1, 2018 - September 30, 2019).

  • Z71.83 - Encounter for nonprocreative genetic counseling

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 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.

Convert Z31.5 to ICD-9

The following crosswalk between ICD-10 to ICD-9 is based based on the General Equivalence Mappings (GEMS) information:

  • V26.33 - Genetic counseling (Approximate Flag)

Present on Admission (POA)

Z31.5 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.

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

Synonyms

The following clinical terms are approximate synonyms:

  • Genetic counseling done
  • Genetic counseling for heritable disorder with fetus at risk done
  • Genetic counseling for heritable disorder with patient at risk done

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 Z31.5 are found in the index:


Information for Patients


Genetic Counseling

Genetic counseling provides information and support to people who have, or may be at risk for, genetic disorders. A genetic counselor meets with you to discuss genetic risks. The counseling may be for yourself or a family member. Or you may get it when you are planning or expecting a baby. You may follow up with genetic testing.

There are many reasons to seek genetic counseling. You may consider it if you

  • Have a personal or family history of a genetic condition or birth defect
  • Are pregnant or planning to be pregnant after age 35
  • Already have a child with a genetic disorder or birth defect
  • Have had two or more pregnancy losses or a baby who died
  • Have had ultrasound or screening tests that suggest a possible problem

Genetics Home Reference

  • Genetic counseling (Medical Encyclopedia)

[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.