ICD-10-CM Code Z43.4

Encounter for attention to other artificial openings of digestive tract

Version 2020 Billable Code POA Exempt

Valid for Submission

Z43.4 is a billable code used to specify a medical diagnosis of encounter for attention to other artificial openings of digestive tract. 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.

ICD-10:Z43.4
Short Description:Encounter for attn to oth artif openings of digestive tract
Long Description:Encounter for attention to other artificial openings of digestive tract

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 Z43.4 are found in the index:


Diagnostic Related Groups

The ICD-10 code Z43.4 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.

  • 393 - OTHER DIGESTIVE SYSTEM DIAGNOSES WITH MCC
  • 394 - OTHER DIGESTIVE SYSTEM DIAGNOSES WITH CC
  • 395 - OTHER DIGESTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC

Present on Admission (POA)

Z43.4 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

Convert Z43.4 to ICD-9

  • V55.4 - Atten to enterostomy NEC

Code Classification

  • Factors influencing health status and contact with health services (Z00–Z99)
    • Encounters for other specific health care (Z40-Z53)
      • Encounter for attention to artificial openings (Z43)

Code History

  • 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

Information for Patients


Ostomy

An ostomy is surgery to create an opening (stoma) from an area inside the body to the outside. It treats certain diseases of the digestive or urinary systems. It can be permanent, when an organ must be removed. It can be temporary, when the organ needs time to heal. The organ could be the small intestine, colon, rectum, or bladder. With an ostomy, there must be a new way for wastes to leave the body.

There are many different types of ostomy. Some examples are

  • Ileostomy - the bottom of the small intestine (ileum) is attached to the stoma. This bypasses the colon, rectum and anus.
  • Colostomy - the colon is attached to the stoma. This bypasses the rectum and the anus.
  • Urostomy - the tubes that carry urine to the bladder are attached to the stoma. This bypasses the bladder.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases


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