2027 ICD-10-CM Diagnosis Code Z31.430Encounter of female for testing for genetic disease carrier status for procreative management
Z31.430 is a billable ICD-10-CM diagnosis code for encounter of female for testing for genetic disease carrier status for procreative management. 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 Z31.430.
Present on Admission (POA)Billing
Z31.430 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 Z31.430: its own notes plus those printed at Z31.43, Z31.4, Z31, and Chapter 21. A note printed at a category, block or chapter applies to every code under it.
Excludes1
Not coded here: the excluded code is never reported together with this one, unless the two conditions are unrelated.
- nonprocreative genetic testing (Z13.7-)
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.
Use Additional Code
Add a second code, after this one, to fully describe the condition.
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 Z31.430, its category, or a range that includes it.
Excludes1 1
These codes carry an Excludes1 note naming Z31.430: they are not reported together with it, unless the two conditions are unrelated.
Excludes2 4
These codes carry an Excludes2 note naming Z31.430: its condition is not part of those codes, and both may be reported when the patient has both.
- Z36 Encounter for antenatal screening of mothergenetic counseling and testing (Z31.43-, Z31.5) names Z31.43-, which includes this code
- 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
Alphabetical index entries that point to this code.
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Patient EducationClinical
Genetic Testing
Genetic testing is a type of medical test that looks for changes, sometimes called variants or mutations, in your DNA. DNA contains the genetic instructions in all living things. Often, these changes have no effect, but sometimes, even a small change in DNA can cause disease or other health conditions.
The full article covers:
- What is genetic testing?
- What are the different ways to get genetic tests?
- Why is genetic testing done?
- How is genetic testing done?
- What are the benefits of genetic testing?
- What are the drawbacks of genetic testing?
- How do I decide whether to be tested?
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert Z31.430 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About Z31.430Overview
Is Z31.430 a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report encounter of female for testing for genetic disease carrier status for procreative management on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What MS-DRG does Z31.430 group to?
On inpatient claims, encounter of female for testing for genetic disease carrier status for procreative management 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 Z31.430 be a principal diagnosis?
No. The Medicare Code Editor rejects this code as a principal diagnosis because encounter of female for testing for genetic disease carrier status for procreative management describes a circumstance that influences health status rather than a current illness. Report it as a secondary diagnosis.
Is Z31.430 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 encounter of female for testing for genetic disease carrier status for procreative management 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.
Can Z31.430 be reported with a code from Z13.7?
Not as a rule. The Excludes1 note at Z31.43, which applies to Z31.430, lists "nonprocreative genetic testing (Z13.7-)". An Excludes1 note means the excluded code is never reported together with this one; the only exception is when the two conditions are unrelated to each other (Official Guidelines, Section I.A.12.a).
