2026 ICD-10-CM Diagnosis Code Z43.5Encounter for attention to cystostomy

ICD-10-CM Codes›Z00–Z99›Z40-Z53›Z43

ICD-10-CM Z43.5
CMSSource: CMS FY 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

Z43.5 is a billable ICD-10-CM diagnosis code for encounter for attention to cystostomy. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026) and groups to MS-DRG 698 through 700. The code is exempt from POA reporting. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Other aftercare encounter.

Code Identity

ICD-10-CM Code
Z43.5
Billable Status
Yes — Valid for Submission
Code Describes
Encounter for attention to cystostomy
Short Description
Encounter for attention to cystostomy
Same as the full description in the CMS dataset.
Parent Code
Z43
Encounter for attention to artificial openings

Code Classification

ChapterZ00–Z99Factors influencing health status and contact with health services
SectionZ40-Z53Encounters for other specific health care
CategoryZ43Encounter for attention to artificial openings
This CodeZ43.5Encounter for attention to cystostomy

Present on Admission (POA)Billing

Z43.5 is exempt from POA reporting on inpatient claims to general acute care hospitals. Review other POA exempt codes.

Index to Diseases and InjuriesGuidance

Alphabetical index entries that point to this code.

External Cause of Injuries IndexGuidance

References for this code in the External Cause of Injuries Index.

    • Admission(for)
      • attention to artificial opening (of)
        • cystostomy
    • Admission(for)
      • removal of
        • cystostomy catheter
    • Attention(to)
      • artificial
        • opening (of)
          • urinary tract NEC
            • cystostomy
    • Attention(to)
      • cystostomy
    • Cystostomy
      • attention to

Clinical ClassificationClinical

AHRQ’s CCSR groups this code into broader clinical categories.

CCSR FAC010
Other aftercare encounter
Default principal diagnosis: inpatient Yes · outpatient Yes

Patient EducationClinical

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.

Read the full article at MedlinePlus

Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.

Convert Z43.5 to ICD-9-CMHistory

The closest ICD-9-CM equivalents under the General Equivalence Mappings.

ICD-9-CM
V55.5 Atten to cystostomy
Exact Match The mapping is direct, with no qualifiers.

Code HistoryHistory

FY 2016AddedAdded to the ICD-10-CM code setEffective October 1, 2015, the first year of ICD-10-CM.
FY 2017–2025No changes
FY 2026CurrentCurrent code set, no changesEffective October 1, 2025 through September 30, 2026.

Questions About Z43.5Overview

Is Z43.5 (Encounter for attention to artificial openings) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report encounter for attention to cystostomy on HIPAA-covered claims from October 1, 2025 through September 30, 2026.

What MS-DRG does Z43.5 group to?

When encounter for attention to cystostomy is the principal diagnosis on an inpatient stay, it groups to MS-DRG 698, 699, 700, with relative weights from 0.6899 to 1.6544 depending on complications. Higher weights mean higher Medicare reimbursement.

Is Z43.5 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 attention to cystostomy on inpatient claims.

What is the ICD-9 equivalent of Z43.5?

Under the General Equivalence Mappings, encounter for attention to cystostomy converts to ICD-9-CM V55.5 (atten to cystostomy). The mapping is a direct match.