All ICD10 Codes
Z43Not billable, use a more specific code below

Encounter for attention to artificial openings

In Encounters for other specific health care (Z40-Z53), chapter 21: Factors Influencing Health Status and Contact with Health Services

10 billable codes under Z43: 1 is a CC; 9 map to HCC 463 (Artificial Openings for Feeding or Elimination), HCC 211 (Respirator Dependence/Tracheostomy Status/Complications).A CC or MCC (major CC) is a secondary diagnosis that raises the MS-DRG payment. An HCC counts toward a Medicare Advantage patient's risk score.

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Instructional notes

Includes: conditions that are coded here

  • closure of artificial openings
  • passage of sounds or bougies through artificial openings
  • reforming artificial openings
  • removal of catheter from artificial openings
  • toilet or cleansing of artificial openings

Excludes1: not coded here, use a different code

Excludes2: not included here, code separately if applicable

  • fitting and adjustment of prosthetic and other devices (Z44-Z46)

Also applies, from Encounters for other specific health care (Z40-Z53)

These notes sit on Z40-Z53 and apply to every code under it, including Z43.

Includes: conditions that are coded here

  • Categories Z40-Z53 are intended for use to indicate a reason for care. They may be used for patients who have already been treated for a disease or injury, but who are receiving aftercare or prophylactic care, or care to consolidate the treatment, or to deal with a residual state

Excludes2: not included here, code separately if applicable

  • follow-up examination for medical surveillance after treatment (Z08-Z09)

Official coding guidelines

From the ICD-10-CM Official Guidelines for Coding and Reporting, FY 2027 (CMS and NCHS). Links open the PDF at the right page.

Covers when and how to use Z codes (Z00-Z99) for encounters and supplementary information, including contact, status, history, screening, aftercare, exams, and social determinants of health.

Read Section I.C.21 (page 92)

All codes under Z43

Z43 can't be used on a claim. Pick a billable code below; grey headings group them.

Z43 MS-DRGs

As the principal diagnosis, the billable codes under Z43 group to these 13 MS-DRGs (v44.0). Which one applies depends on procedures performed, secondary diagnoses (CC/MCC), and the patient's age and discharge status.

Other codes that refer to Z43

Notes on these codes point to Z43.

  • T80-T88 Excludes2: closure of external stoma (Z43.-)
  • Z08 Excludes1: aftercare following medical care (Z43-Z49, Z51)
  • Z09 Excludes1: aftercare following medical care (Z43-Z49, Z51)
  • Z48 Excludes2: encounter for attention to artificial openings (Z43.-)
  • Z93 Excludes1: artificial openings requiring attention or management (Z43.-)
  • Z98 Excludes2: aftercare (Z43-Z49, Z51)

About the condition

Plain-language background from MedlinePlus (National Library of Medicine), not coding guidance.

Ostomy

An ostomy is surgery to create an opening (stoma) from an area inside the body to the outside. It treats certain diseases of the digestive or urinary systems. It can be permanent, when an organ must be removed. It can be temporary, when the organ needs time to heal. The organ could be the small intestine, colon, rectum, or bladder. With an ostomy, there must be a new way for wastes to leave the body.

Read more about ostomy on MedlinePlus

Code history

Valid since FY2016, when ICD-10-CM took effect on October 1, 2015. No changes since.