Z31.4 Encounter for procreative investigation and testing

Not billable (header)Chapter 21

Report one of the more specific codes below.

Check coverage with this diagnosis

Codes under this one

Z31.41 Encounter for fertility testing
Z31.42 Aftercare following sterilization reversal
Z31.43 Encounter for genetic testing of female for procreative managementHeader
Z31.44 Encounter for genetic testing of male for procreative managementHeader
Z31.49 Encounter for other procreative investigation and testing

Instructional notes

Chapter 21

Notes

Z codes represent reasons for encounters. A corresponding procedure code must accompany a Z code if a procedure is performed. Categories Z00-Z99 are provided for occasions when circumstances other than a disease, injury or external cause classifiable to categories A00-Y89 are recorded as 'diagnoses' or 'problems'. This can arise in two main ways:
(a) When a person who may or may not be sick encounters the health services for some specific purpose, such as to receive limited care or service for a current condition, to donate an organ or tissue, to receive prophylactic vaccination (immunization), or to discuss a problem which is in itself not a disease or injury.
(b) When some circumstance or problem is present which influences the person's health status but is not in itself a current illness or injury.

Z31

Excludes2Not included here: the patient may have both; report both when both are present.

complications associated with artificial fertilization (N98.-)
female infertility (N97.-)
male infertility (N46.-)

This code

Excludes1Not coded here: never report with this code, except when the two conditions are unrelated.

postvasectomy sperm count (Z30.8)

Chapter 21: Factors influencing health status and contact with health services · Z30-Z39 Persons encountering health services in circumstances related to reproduction (Z30-Z39)

Source: ICD-10-CM FY 2027 code descriptions and tabular list (CMS and CDC National Center for Health Statistics), effective 2026-10-01 through 2027-09-30 · CMS ICD-10 files. HCC mapping: CMS-HCC V28, payment year 2027. As of 2026-11-04.

Coverage and payment depend on the claim details; confirm with the Medicare Administrative Contractor.