2027 ICD-10-CM Diagnosis Code Z31.42Aftercare following sterilization reversal
Z31.42 is a billable ICD-10-CM diagnosis code for aftercare following sterilization reversal. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 951. The code is not accepted as a principal diagnosis by the Medicare Code Editor and exempt from POA reporting. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Contraceptive and procreative management.
Code Identity
Code Classification
Code EditsBilling
Medicare Code Editor checks that affect claim validity for Z31.42.
Present on Admission (POA)Billing
Z31.42 is exempt from POA reporting on inpatient claims to general acute care hospitals. Review the other POA exempt codes in Persons encountering health services in circumstances related to reproduction (Z30-Z39).
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to Z31.42: its own notes plus those printed at Z31.4, Z31, and Chapter 21. A note printed at a category, block or chapter applies to every code under it.
Applicable To
Conditions this code is used for: synonyms of the title or, for "other specified" codes, the conditions assigned to it. The list is not exhaustive.
- Sperm count following sterilization reversal
Excludes1
Not coded here: the excluded code is never reported together with this one, unless the two conditions are unrelated.
Excludes2
Not included here: the excluded condition is not part of this code, but a patient may have both, so both codes may be reported.
Notes
General instructions on how these codes are used.
- Z codes represent reasons for encounters. A corresponding procedure code must accompany a Z code if a procedure is performed. Categories Z00-Z99 are provided for occasions when circumstances other than a disease, injury or external cause classifiable to categories A00-Y89 are recorded as 'diagnoses' or 'problems'. This can arise in two main ways:
- (a) When a person who may or may not be sick encounters the health services for some specific purpose, such as to receive limited care or service for a current condition, to donate an organ or tissue, to receive prophylactic vaccination (immunization), or to discuss a problem which is in itself not a disease or injury.
- (b) When some circumstance or problem is present which influences the person's health status but is not in itself a current illness or injury.
Source: CMS ICD-10-CM Tabular List. How to read instructional notes.
Referenced in Other NotesGuidance
Instructional notes printed at other codes that name Z31.42, its category, or a range that includes it.
Excludes1 3
These codes carry an Excludes1 note naming Z31.42: they are not reported together with it, unless the two conditions are unrelated.
- Z30.8 Encounter for other contraceptive managementsperm count following sterilization reversal (Z31.42)
- Z48.816 Encounter for surgical aftercare following surgery on the genitourinary systemencounter for aftercare following sterilization reversal (Z31.42)
- Z13.7 Encounter for screening for genetic and chromosomal anomaliesgenetic testing for procreative management (Z31.4-) names Z31.4-, which includes this code
Excludes2 3
These codes carry an Excludes2 note naming Z31.42: its condition is not part of those codes, and both may be reported when the patient has both.
- Block Z00-Z13 Persons encountering health services for examinations
- Z70 Counseling related to sexual attitude, behavior and orientation
- Z71 Persons encountering health services for other counseling and medical advice, not elsewhere classified
Index to Diseases and InjuriesGuidance
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Patient EducationClinical
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.
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert Z31.42 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About Z31.42Overview
What is the ICD-10 code for aftercare following sterilization reversal?
The ICD-10-CM code for aftercare following sterilization reversal is Z31.42 (sometimes written as Z3142). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
Is Z31.42 (Encounter for procreative investigation and testing) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report aftercare following sterilization reversal on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What MS-DRG does Z31.42 group to?
On inpatient claims, aftercare following sterilization reversal maps to MS-DRG 951 (other Factors Influencing Health Status), which carries a relative weight of 0.5574. Higher weights mean higher Medicare reimbursement.
Can Z31.42 be a principal diagnosis?
No. The Medicare Code Editor rejects this code as a principal diagnosis because aftercare following sterilization reversal describes a circumstance that influences health status rather than a current illness. Report it as a secondary diagnosis.
Is Z31.42 exempt from POA reporting?
Yes. CMS lists this code among those exempt from present on admission reporting, so hospitals do not assign a POA indicator for aftercare following sterilization reversal on inpatient claims. The code appears in the Persons encountering health services in circumstances related to reproduction (Z30-Z39) range of the CMS exempt list.
