Z43 ICD-10-CM Code: Encounter for attention to artificial openings
Z43 is not a CMS-HCC payment code. MEAT criteria · RAF Calculator · free HCC coding tools
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FY 2026 Apr update / Factors influencing health status and contact with health services (Z00-Z99) / Encounters for other specific health care (Z40-Z53)
Z43
Header CodeICD-10-CMOfficial ICD-10-CMCodebook guidanceEncounter for attention to artificial openings
CMS-HCC V28
N/A—
Not mapped
CMS-HCC V24
N/A—
Not mapped
ACA/HHS
N/A—
Not mapped
ESRD/PACE
N/A—
Not mapped
RXHCC
N/A—
Not mapped
Code Book Path
Inclusion Terms
Official- 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 stateInherited from Z40-Z53
Excludes 2
Official- fitting and adjustment of prosthetic and other devices (Z44-Z46)
- follow-up examination for medical surveillance after treatment (Z08-Z09)Inherited from Z40-Z53
Related Codes
Includes
Official- 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
Excludes 1
Official- complications of external stoma (J95.0-, K94.-, N99.5-)
Code First
OfficialNo Code First sequencing instructions are included in this display for Z43. Check the code and parent instructions in the Code Book.
Use Additional
OfficialNo Use Additional Code instructions are included in this display for Z43. Check the code and parent instructions in the Code Book.
Code Also
OfficialNo Code Also instructions are included in this display for Z43. Check the code and parent instructions in the Code Book.
Served edition: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →
- Code
- Z43
- Description
- Encounter for attention to artificial openings
- HCC (V28)
- No CMS-HCC V28 mapping
- RAF reference coefficient
- —
- Billable
- No
- Payment year
- 2026
Coder workflow notes
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What This Code Means
Z43 is the ICD-10-CM diagnosis code for encounter for attention to artificial openings. Z43 sits in the ICD-10-CM chapter for factors influencing health status and contact with health services (z00-z99), within the section covering encounters for other specific health care (z40-z53).
Header codes like Z43 cannot be reported on claims directly; they organize child codes that share clinical context. Coders should select the billable child code that matches the documented presentation and then verify its current source-backed HCC mapping. Do not infer a child code or risk adjustment value from the header alone.
HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for Z43 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Includes
- 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