ICD-10-CM Code Z40.03

Encounter for prophylactic removal of fallopian tube(s)

Version 2020 Billable Code Diagnoses For Females Only POA Exempt

Valid for Submission

Z40.03 is a billable code used to specify a medical diagnosis of encounter for prophylactic removal of fallopian tube(s). The code is valid for the year 2020 for the submission of HIPAA-covered transactions. The code is exempt from present on admission (POA) reporting for inpatient admissions to general acute care hospitals.

The code Z40.03 is applicable to female patients only. It is clinically and virtually impossible to use this code on a non-female patient.

ICD-10:Z40.03
Short Description:Encounter for prophylactic removal of fallopian tube(s)
Long Description:Encounter for prophylactic removal of fallopian tube(s)

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 Z40.03 are found in the index:


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:

  • 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 .

Diagnostic Related Groups

The ICD-10 code Z40.03 is grouped in the following groups for version MS-DRG V37.0 What are Diagnostic Related Groups?
The Diagnostic Related Groups (DRGs) are a patient classification scheme which provides a means of relating the type of patients a hospital treats. The DRGs divides all possible principal diagnoses into mutually exclusive principal diagnosis areas referred to as Major Diagnostic Categories (MDC).
applicable from 10/01/2019 through 09/30/2020.

  • 742 - UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITH CC/MCC
  • 743 - UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC

Present on Admission (POA)

Z40.03 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 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

Replacement Code

Z4003 replaces the following previously assigned ICD-10 code(s):

  • Z40.09 - Encounter for prophylactic removal of other organ

Convert Z40.03 to ICD-9

  • V50.49 - Prphylct orgn rmvl other (Approximate Flag)

Code Classification

  • Factors influencing health status and contact with health services (Z00–Z99)
    • Encounters for other specific health care (Z40-Z53)
      • Encounter for prophylactic surgery (Z40)

Code History

  • FY 2018 - Code Added, effective from 10/1/2017 through 9/30/2018
  • FY 2019 - Code Updated, effective from 10/1/2018 through 9/30/2019
    • New Description: Encounter for prophylactic removal of fallopian tube(s)
    • Previous Description: Encounter for prophylactic removal of fallopian tube(s )
  • FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020