Version 2024

2024 ICD-10-CM Diagnosis Code Z49.32

Encounter for adequacy testing for peritoneal dialysis

ICD-10-CM Code:: Z49.32
Short Description:: Encounter for adequacy testing for peritoneal dialysis
Is Billable?: Yes - Valid for Submission
Code Navigator:

1. Approximate Synonyms
2. Clinical Classification
3. Tabular List of Diseases and Injuries
4. Index to Diseases and Injuries References
5. Code Edits
6. Diagnostic Related Groups - MS-DRG Mapping
7. Present on Admission (POA)
8. Convert to ICD-9 Code
9. Patient Education
10. Other Codes Used Similar Conditions
11. Code History

Code Classification

Factors influencing health status and contact with health services
(Z00–Z99)
- Encounters for other specific health care
  (Z40-Z53)
  - Encounter for care involving renal dialysis
    (Z49)

Z49.32 is a billable diagnosis code used to specify a medical diagnosis of encounter for adequacy testing for peritoneal dialysis. The code is valid during the current fiscal year for the submission of HIPAA-covered transactions from October 01, 2023 through September 30, 2024. The code is exempt from present on admission (POA) reporting for inpatient admissions to general acute care hospitals.

This code describes a circumstance which influences the patient's health status but not a current illness or injury. The code is unacceptable as a principal diagnosis.

Approximate Synonyms

The following clinical terms are approximate synonyms or lay terms that might be used to identify the correct diagnosis code:

Complies with analysis of peritoneal dialysate
Inadequate monitoring of dose delivery of peritoneal dialysis
Non-compliance with analysis of peritoneal dialysate
Peritoneal dialysis finding

Clinical Classification

Clinical Category	CCSR Category Code	Inpatient Default CCSR	Outpatient Default CCSR
Chronic kidney disease	GEN003	X - Not applicable.	Y - Yes, default outpatient assignment for principal diagnosis or first-listed diagnosis.
Other aftercare encounter	FAC010	X - Not applicable.	N - Not default outpatient assignment for principal diagnosis or first-listed diagnosis.

Tabular List of Diseases and Injuries

The following annotation back-references are applicable to this diagnosis code. The Tabular List of Diseases and Injuries is a list of ICD-10-CM codes, organized "head to toe" into chapters and sections with coding notes and guidance for inclusions, exclusions, descriptions and more.

Inclusion Terms

Encounter for peritoneal equilibration test

Index to Diseases and Injuries References

The following annotation back-references for this diagnosis code are found in the injuries and diseases index. The Index to Diseases and Injuries is an alphabetical listing of medical terms, with each term mapped to one or more ICD-10-CM code(s).

- Test, tests, testing (for)
- - adequacy (for dialysis)
  - - peritoneal - Z49.32

Code Edits

The Medicare Code Editor (MCE) detects and reports errors in the coding of claims data. The following ICD-10-CM Code Edits are applicable to this code:

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.

Z49.32 is grouped with Diagnostic Related Groups - MS-DRG Mapping

Diagnostic Related Groups (DRGs) are a classification system used to group together diagnosis codes for the purpose of reimbursement and healthcare management. DRGs are used to standardize the way hospitals and other providers are paid for inpatient services. In this system patients are grouped together based on their principal diagnosis in areas referred to as Major Diagnostic Categories (MDC). Once a patient is assigned a particular diagnostic category, providers receive a predetermined payment rate for the services rendered. This reimbursement rate is often fixed and is meant to cover the cost of care for that patient. Reimbursement is also affected by the relative weight of a diagnostic related group based on the severity of a patient's illness and the associated cost of care during hospitalization.

Diagnostic related groups encourage healthcare providers to focus on quality and efficiency in patient care while managing costs effectively. The diagnosis code is present in the following groups for version MS-DRG V41.0 applicable from 10/01/2023 through 09/30/2024.

MS-DRG	MS-DRG Title	MCD	Relative Weight
698	OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MCC	11	1.6544
699	OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH CC	11	1.0208
700	OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITHOUT CC/MCC	11	0.7083

The relative weight of a diagnostic related group determines the reimbursement rate based on the severity of a patient's illness and the associated cost of care during hospitalization.

Present on Admission (POA)

Z49.32 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	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 Z49.32 to ICD-9-CM

ICD-9-CM Code: V56.32 - Peritoneal dialysis test
Approximate Flag - The approximate mapping means there is not an exact match between the ICD-10 and ICD-9 codes and the mapped code is not a precise representation of the original code.

Patient Education

Dialysis

When your kidneys are healthy, they clean your blood. They also make hormones that keep your bones strong and your blood healthy. When your kidneys fail, you need treatment to replace the work your kidneys used to do. Unless you have a kidney transplant, you will need a treatment called dialysis.

There are two main types of dialysis. Both types filter your blood to rid your body of harmful wastes, extra salt, and water.:

Hemodialysis uses a machine. It is sometimes called an artificial kidney. You usually go to a special clinic for treatments several times a week.
Peritoneal dialysis uses the lining of your abdomen, called the peritoneal membrane, to filter your blood.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

[Learn More in MedlinePlus]

Code History

FY 2024 - No Change, effective from 10/1/2023 through 9/30/2024
FY 2023 - No Change, effective from 10/1/2022 through 9/30/2023
FY 2022 - No Change, effective from 10/1/2021 through 9/30/2022
FY 2021 - No Change, effective from 10/1/2020 through 9/30/2021
FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020
FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016. This was the first year ICD-10-CM was implemented into the HIPAA code set.