Valid for Submission
Z3A.16 is a billable code used to specify a medical diagnosis of 16 weeks gestation of pregnancy. The code is valid for the year 2020 for the submission of HIPAA-covered transactions. The ICD-10-CM code Z3A.16 might also be used to specify conditions or terms like gestation period, 16 weeks. The code is exempt from present on admission (POA) reporting for inpatient admissions to general acute care hospitals.
The code Z3A.16 is applicable to female patients aged 12 through 55 years inclusive. It is clinically and virtually impossible to use this code on a non-female patient outside the stated age range.
|Short Description:||16 weeks gestation of pregnancy|
|Long Description:||16 weeks gestation of pregnancy|
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 Z3A.16 are found in the index:
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:
- Maternity diagnoses - Maternity. Age range is 12–55 years inclusive (e.g., diabetes in pregnancy, antepartum pulmonary complication).
- Diagnoses for females only - Medicare Code Editor detects inconsistencies between a patient’s sex and any diagnosis on the patient’s record, this code applies to 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.
The following clinical terms are approximate synonyms or lay terms that might be used to identify the correct diagnosis code:
- Gestation period, 16 weeks
Present on Admission (POA)
Z3A.16 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. Review other POA exempt codes here .
CMS POA Indicator Options and Definitions
|POA Indicator Code||POA Reason for Code||CMS will pay the CC/MCC DRG?|
|Y||Diagnosis was present at time of inpatient admission.||YES|
|N||Diagnosis was not present at time of inpatient admission.||NO|
|U||Documentation insufficient to determine if the condition was present at the time of inpatient admission.||NO|
|W||Clinically undetermined - unable to clinically determine whether the condition was present at the time of inpatient admission.||YES|
|1||Unreported/Not used - Exempt from POA reporting. ||NO|
Convert Z3A.16 to ICD-9
Factors influencing health status and contact with health services (Z00–Z99)
Persons encountering health services in circumstances related to reproduction (Z30-Z39)
- FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016
(First year ICD-10-CM implemented into the HIPAA code set)
- FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
- FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
- FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
- FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020