Z31.438Encounter for other genetic testing of female for procreative management

Z31.438 is the ICD-10-CM diagnosis code for encounter for other genetic testing of female for procreative management. It belongs to category Z31 (encounter for procreative management), block Z30-Z39 (persons encountering health services in circumstances related to reproduction) and chapter 21 (factors influencing health status and contact with health services). It is billable, so it can be reported on its own for dates of service from October 1, 2026 through September 30, 2027.

Within Z31.43, choose Z31.438 (for other genetic testing of female for procreative management) only when documentation doesn't support a more specific option: of female for testing for genetic disease carrier status for procreative management (Z31.430).

It is not a CC or MCC, so as a secondary diagnosis it doesn't change the MS-DRG severity level.

In MS-DRG v44.0, it is part of the grouping logic for DRG 951 (Other Factors Influencing Health Status, relative weight 0.5577), in MDC 23 (Factors Influencing Health Status and Other Contacts with Health Services), as a principal or secondary diagnosis. The DRG a claim lands in depends on the principal diagnosis, procedures and any CC/MCC secondary diagnoses.

It is not acceptable as the principal diagnosis for an inpatient stay; it may be reported as a secondary diagnosis.

It is on the CMS list of diagnoses consistent only with female patients (the sex-conflict edit itself was retired in FY2025).

It is exempt from present-on-admission (POA) reporting, so no POA indicator is required.

It has been part of ICD-10-CM since the code set took effect on October 1, 2015 and hasn't changed since.

Before ICD-10, this condition was coded in ICD-9-CM as V26.32 (other genetic testing of female).