2027 ICD-10-CM Diagnosis Code Z31.5Encounter for procreative genetic counseling
Z31.5 is a billable ICD-10-CM diagnosis code for encounter for procreative genetic counseling. 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. Coders also document this condition as genetic counseling done. 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 Z31.5.
Present on Admission (POA)Billing
Z31.5 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).
Approximate SynonymsGuidance
Alternate terms and clinical phrases that map to this code.
- Genetic counseling done
- Genetic counseling for heritable disorder with fetus at risk done
- Genetic counseling for heritable disorder with patient at risk done
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to Z31.5: its own notes plus those printed at Z31 and Chapter 21. A note printed at a category, block or chapter applies to every code under it.
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 Z31.5, its category, or a range that includes it.
Excludes1 1
These codes carry an Excludes1 note naming Z31.5: they are not reported together with it, unless the two conditions are unrelated.
- Z71.83 Encounter for nonprocreative genetic counselingcounseling for procreative genetics (Z31.5)
Excludes2 4
These codes carry an Excludes2 note naming Z31.5: 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)
- 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 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.
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert Z31.5 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About Z31.5Overview
What is the ICD-10 code for encounter for procreative genetic counseling?
The ICD-10-CM code for encounter for procreative genetic counseling is Z31.5 (sometimes written as Z315). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
Is Z31.5 (Encounter for procreative management) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report encounter for procreative genetic counseling on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What MS-DRG does Z31.5 group to?
On inpatient claims, encounter for procreative genetic counseling 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 Z31.5 be a principal diagnosis?
No. The Medicare Code Editor rejects this code as a principal diagnosis because encounter for procreative genetic counseling describes a circumstance that influences health status rather than a current illness. Report it as a secondary diagnosis.
Is Z31.5 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 for procreative genetic counseling 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.
