October 1 update. Our PDGM and ICD-10 tools now use the FY2027 code set: 190 codes added, 30 deleted, and no existing code changed clinical group.

See what changed

ICD-10 · PDGM grouping

Z31 Encounter for procreative management

All 20 codes in the Z31 family, with the PDGM clinical group, comorbidity subgroup and primary-position rule CMS assigns, read from the CMS grouper crosswalk v07.2.26 and the CDC FY2027 code file.

ICD-10-CM FY2027 · CMS grouper v07.2.26

Codes in family

20

Can lead a claim

0

Cannot lead a claim

20

What CMS assigns to Z31

None of the 20 codes is assigned a clinical group. None of the 20 is assigned a comorbidity subgroup. None can lead a claim.

Every code in Z31

Descriptions are CDC’s FY2027 wording; where CMS’s grouper abbreviates one, its form is shown beneath.

CodeDescriptionPrimary positionClinical groupComorbidity subgroup
Z31.0Encounter for reversal of previous sterilizationCannot lead a claimPrincipal diagnosis not assigned to a clinical groupNoneNone
Z31.4 Encounter for procreative investigation and testing
Z31.41Encounter for fertility testingCannot lead a claimPrincipal diagnosis not assigned to a clinical groupNoneNone
Z31.42Aftercare following sterilization reversalCannot lead a claimPrincipal diagnosis not assigned to a clinical groupNoneNone
Z31.43 Encounter for genetic testing of female for procreative management
Z31.430Encounter of female for testing for genetic disease carrier status for procreative managementCMS: Encntr fem for test for genetc dis carrier stat for pro mgmtCannot lead a claimPrincipal diagnosis not assigned to a clinical groupNoneNone
Z31.438Encounter for other genetic testing of female for procreative managementCMS: Encounter for oth genetic testing of female for pro mgmtCannot lead a claimPrincipal diagnosis not assigned to a clinical groupNoneNone
Z31.44 Encounter for genetic testing of male for procreative management
Z31.440Encounter of male for testing for genetic disease carrier status for procreative managementCMS: Encntr male test for genetic dis carrier status for pro mgmtCannot lead a claimPrincipal diagnosis not assigned to a clinical groupNoneNone
Z31.441Encounter for testing of male partner of patient with recurrent pregnancy lossCMS: Encntr for testing of male prtnr of pt w recur preg lossCannot lead a claimPrincipal diagnosis not assigned to a clinical groupNoneNone
Z31.448Encounter for other genetic testing of male for procreative managementCMS: Encounter for oth genetic testing of male for pro mgmtCannot lead a claimPrincipal diagnosis not assigned to a clinical groupNoneNone
Z31.49Encounter for other procreative investigation and testingCannot lead a claimPrincipal diagnosis not assigned to a clinical groupNoneNone
Z31.5Encounter for procreative genetic counselingCannot lead a claimPrincipal diagnosis not assigned to a clinical groupNoneNone
Z31.6 Encounter for general counseling and advice on procreation
Z31.61Procreative counseling and advice using natural family planningCMS: Procreat counseling and advice using natural family planningCannot lead a claimPrincipal diagnosis not assigned to a clinical groupNoneNone
Z31.62Encounter for fertility preservation counselingCannot lead a claimPrincipal diagnosis not assigned to a clinical groupNoneNone
Z31.69Encounter for other general counseling and advice on procreationCMS: Encounter for oth general cnsl and advice on procreationCannot lead a claimPrincipal diagnosis not assigned to a clinical groupNoneNone
Z31.7Encounter for procreative management and counseling for gestational carrierCMS: Enctr for pro mgmt and counseling for gestational carrierCannot lead a claimPrincipal diagnosis not assigned to a clinical groupNoneNone
Z31.8 Encounter for other procreative management
Z31.81Encounter for male factor infertility in female patientCannot lead a claimPrincipal diagnosis not assigned to a clinical groupNoneNone
Z31.82Encounter for Rh incompatibility statusCannot lead a claimPrincipal diagnosis not assigned to a clinical groupNoneNone
Z31.83Encounter for assisted reproductive fertility procedure cycleCMS: Encounter for assisted reprodctv fertility procedure cycleCannot lead a claimPrincipal diagnosis not assigned to a clinical groupNoneNone
Z31.84Encounter for fertility preservation procedureCannot lead a claimPrincipal diagnosis not assigned to a clinical groupNoneNone
Z31.89Encounter for other procreative managementCannot lead a claimPrincipal diagnosis not assigned to a clinical groupNoneNone
Z31.9Encounter for procreative management, unspecifiedCannot lead a claimPrincipal diagnosis not assigned to a clinical groupNoneNone

Sources: CMS HH PPS Grouper Software v07.2.26, effective 2026-10-01, for the clinical group, comorbidity subgroup, code-first conventions and primary-position flags; CDC NCHS ICD-10-CM FY2027 code descriptions for the family title and code wording. This is the crosswalk Medicare runs a claim through. Grouping also depends on admission source, timing, the OASIS functional items and the rest of the diagnosis list.

The monthly home health regs digest

What CMS changed, what's due next, and what to do about it — one email a month, no fluff. Read the first issue