Question 1

What is ICD-10 code Z31.440?

Accepted Answer

Z31.440 is the ICD-10-CM diagnosis code for encounter of male for testing for genetic disease carrier status for procreative management. A genetic screening test for a man to determine if he carries genes for inherited diseases before or during pregnancy planning. Z31.440 sits in the ICD-10-CM chapter for factors influencing health status and contact with health services (z00-z99), within the section covering persons encountering health services in circumstances related to reproduction (z30-z39).

Z31.440 is a billable ICD-10-CM code but does not map to a payment HCC under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can be reported on Medicare Advantage encounter data submissions but it does not contribute to a beneficiary's RAF score and therefore does not affect risk-adjusted payments to the plan.

This code is specifically for carrier status testing in males for procreative management purposes.

Question 2

Is Z31.440 an HCC code?

Accepted Answer

No. Z31.440 is a billable ICD-10-CM code but does not map to any payment HCC category under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can still be reported on Medicare Advantage encounter data submissions, but it does not contribute to the beneficiary's Risk Adjustment Factor (RAF) score and therefore does not affect the risk-adjusted capitation payment to the plan. V28 reached 100% phase-in for payment year 2026.

Question 3

Is Z31.440 billable?

Accepted Answer

Yes. Z31.440 is a billable ICD-10-CM code that can be reported on professional and institutional claims as a primary or secondary diagnosis when the provider documentation supports the specific condition described. Billable codes in ICD-10-CM are coded to the highest level of specificity available for the documented diagnosis. Z31.440 is current for fiscal year 2026 and remains in the active CMS ICD-10-CM code set published by the National Center for Health Statistics.

Question 4

What is the V28 vs V24 difference for Z31.440?

Accepted Answer

Z31.440 does not map to a payment HCC under either the CMS-HCC V28 risk adjustment model or the older V24 model. V28 reached 100% phase-in for payment year 2026, replacing V24 which was used during the PY2024–PY2025 transition. Because neither model rewards Z31.440 with a risk adjustment factor, it contributes zero to a Medicare Advantage beneficiary's RAF score in either version. Coders should check whether provider documentation supports a more specific child code that does map to a payment HCC.

Question 5

What should coders know when reporting Z31.440?

Accepted Answer

This code is specifically for carrier status testing in males for procreative management purposes Document which genetic conditions are being screened for and the results of the testing

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Z31.440

Is Z31.440 an HCC code?

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Z31.440 ICD-10-CM Code: Encounter of male for testing for genetic disease carrier status for procreative management

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Z31.440

Is Z31.440 an HCC code?

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Child Codes

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Open Z31.440 in the Interactive Encoder