2027 ICD-10-CM Diagnosis Code Z55.6Problems related to health literacy
Z55.6 is a billable ICD-10-CM diagnosis code for problems related to health literacy. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 951. The code is not accepted as a principal diagnosis by the Medicare Code Editor and exempt from POA reporting. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Socioeconomic/psychosocial factors.
Code Identity
Code Classification
Code EditsBilling
Medicare Code Editor checks that affect claim validity for Z55.6.
Present on Admission (POA)Billing
Z55.6 is exempt from POA reporting on inpatient claims to general acute care hospitals. Review the other POA exempt codes in Persons with potential health hazards related to socioeconomic and psychosocial circumstances (Z55-Z65).
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to Z55.6: its own notes plus those printed at Z55 and Chapter 21. A note printed at a category, block or chapter applies to every code under it.
Applicable To
Conditions this code is used for: synonyms of the title or, for "other specified" codes, the conditions assigned to it. The list is not exhaustive.
- Difficulty understanding health related information
- Difficulty understanding medication instructions
- Problem completing medical forms
Excludes1
Not coded here: the excluded code is never reported together with this one, unless the two conditions are unrelated.
Notes
General instructions on how these codes are used.
- Z codes represent reasons for encounters. A corresponding procedure code must accompany a Z code if a procedure is performed. Categories Z00-Z99 are provided for occasions when circumstances other than a disease, injury or external cause classifiable to categories A00-Y89 are recorded as 'diagnoses' or 'problems'. This can arise in two main ways:
- (a) When a person who may or may not be sick encounters the health services for some specific purpose, such as to receive limited care or service for a current condition, to donate an organ or tissue, to receive prophylactic vaccination (immunization), or to discuss a problem which is in itself not a disease or injury.
- (b) When some circumstance or problem is present which influences the person's health status but is not in itself a current illness or injury.
Source: CMS ICD-10-CM Tabular List. How to read instructional notes.
Index to Diseases and InjuriesGuidance
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Patient EducationClinical
Health Literacy
Health literacy involves the information that people need to be able to make good decisions about health. There are two parts:
The full article covers:
- What is health literacy?
- Which factors can affect health literacy?
- Why is health literacy important?
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Code History & ChangesHistory
Replacement Z55.6 replaces the following previously assigned code(s):
- Z55.8 - Other problems related to education and literacy
Questions About Z55.6Overview
What is the ICD-10 code for problems related to health literacy?
The ICD-10-CM code for problems related to health literacy is Z55.6 (sometimes written as Z556). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
Is Z55.6 (Problems related to education and literacy) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report problems related to health literacy on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What MS-DRG does Z55.6 group to?
On inpatient claims, problems related to health literacy maps to MS-DRG 951 (other Factors Influencing Health Status), which carries a relative weight of 0.5574. Higher weights mean higher Medicare reimbursement.
Can Z55.6 be a principal diagnosis?
No. The Medicare Code Editor rejects this code as a principal diagnosis because problems related to health literacy describes a circumstance that influences health status rather than a current illness. Report it as a secondary diagnosis.
Is Z55.6 exempt from POA reporting?
Yes. CMS lists this code among those exempt from present on admission reporting, so hospitals do not assign a POA indicator for problems related to health literacy on inpatient claims. The code appears in the Persons with potential health hazards related to socioeconomic and psychosocial circumstances (Z55-Z65) range of the CMS exempt list.
