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

Z43 Encounter for attention to artificial openings

All 10 codes in the Z43 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

10

Can lead a claim

9

Cannot lead a claim

1

What CMS assigns to Z43

9 of the 10 codes group to Complex Nursing Interventions; 1 is assigned no clinical group. None of the 10 is assigned a comorbidity subgroup. 9 of the 10 can lead a claim.

Every code in Z43

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

CodeDescriptionPrimary positionClinical groupComorbidity subgroup
Z43.0Encounter for attention to tracheostomyCan lead a claimDNone
Z43.1Encounter for attention to gastrostomyCan lead a claimDNone
Z43.2Encounter for attention to ileostomyCan lead a claimDNone
Z43.3Encounter for attention to colostomyCan lead a claimDNone
Z43.4Encounter for attention to other artificial openings of digestive tractCMS: Encounter for attn to oth artif openings of digestive tractCan lead a claimDNone
Z43.5Encounter for attention to cystostomyCan lead a claimDNone
Z43.6Encounter for attention to other artificial openings of urinary tractCMS: Encounter for attn to oth artif openings of urinary tractCan lead a claimDNone
Z43.7Encounter for attention to artificial vaginaCan lead a claimDNone
Z43.8Encounter for attention to other artificial openingsCan lead a claimDNone
Z43.9Encounter for attention to unspecified artificial openingCannot 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.

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