Z31.5 Encounter for procreative genetic counseling

The ICD-10-CM code for Encounter for procreative genetic counseling is Z31.5 (FY2026). It is a billable, claim-ready diagnosis code.

Classification

Chapter

21: Factors influencing health status and contact with health services (Z00-Z99)

Section

Z30-Z39: Persons encountering health services in circumstances related to reproduction (Z30-Z39)

Category Z31

26 codes (20 billable)

FY2026 Status

Stable since FY2024

Also Known As

ICD-10-CM Alphabetic Index entries that lead to Z31.5:

• Counseling (for) › genetic › procreative NEC
• Encounter (with health service) (for) › genetic › counseling › procreative

U.S. Hospital Utilization

• An estimated 100 U.S. inpatient stays in 2022 included Z31.5 among the documented diagnoses.

Source: National Inpatient Sample (NIS), Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality, 2016–2023. National survey-weighted estimates.

Official Coding Guidelines

Counseling Z codes/categories list

The counseling Z codes/categories: Z30.0- Encounter for general counseling and advice on contraception Z31.5 Encounter for procreative genetic counseling Z31.6- Encounter for general counseling and advice on procreation Z32.2 Encounter for childbirth instruction Z32.3 Encounter for childcare instruction Z69 Encounter for mental health services for victim and perpetrator of abuse Z70 Counseling related to sexual attitude, behavior and orientation Z71 Persons encountering health services for other counseling and medical advice, not elsewhere classified

Z15: sequencing/principal-first-listed guidance and counseling

Z15 Genetic susceptibility to disease Genetic susceptibility indicates that a person has a gene that increases the risk of that person developing the disease. Codes from category Z15 should generally not be used as principal or first-listed codes. If the patient has the condition to which he/she is susceptible, and that condition is the reason for the encounter, the code for the current condition should be sequenced first. If the patient is being seen for follow-up after completed treatment for this condition, and the condition no longer exists, a follow-up code should be sequenced first, followed by the appropriate personal history and genetic susceptibility codes. If the purpose of the encounter is genetic counseling associated with procreative management, code Z31.5, Encounter for genetic counseling, should be assigned as the first-listed code, followed by a code from category Z15. Additional codes should be assigned for any applicable family or personal history.

Source: CMS — ICD-10-CM Official Guidelines for Coding and Reporting, FY2026

References

• CMS — ICD-10-CM Official Code Set and Guidelines, FY2026
• CDC/NCHS — ICD-10-CM Files and Browser Tool
• AHRQ — HCUP National Inpatient Sample, Frequencies by Diagnosis Code (2016–2023)