ICD-10-CM Code Z59.1

Inadequate housing

Version 2020 Billable Code Unacceptable Principal Diagnosis POA Exempt

Valid for Submission

Z59.1 is a billable code used to specify a medical diagnosis of inadequate housing. The code is valid for the year 2020 for the submission of HIPAA-covered transactions. The ICD-10-CM code Z59.1 might also be used to specify conditions or terms like access to or within the residence, adequacy of living space - finding, cleanliness of home - finding, crowded living space, damp in house, damp in house, etc The code is exempt from present on admission (POA) reporting for inpatient admissions to general acute care hospitals.

The code Z59.1 describes a circumstance which influences the patient's health status but not a current illness or injury. The code is unacceptable as a principal diagnosis.

ICD-10:Z59.1
Short Description:Inadequate housing
Long Description:Inadequate housing

Tabular List of Diseases and Injuries

The Tabular List of Diseases and Injuries is a list of ICD-10 codes, organized "head to toe" into chapters and sections with guidance for inclusions, exclusions, descriptions and more. The following references are applicable to the code Z59.1:

Inclusion Terms

Inclusion Terms
These terms are the conditions for which that code is to be used. The terms may be synonyms of the code title, or, in the case of "other specified" codes, the terms are a list of the various conditions assigned to that code. The inclusion terms are not necessarily exhaustive. Additional terms found only in the Alphabetic Index may also be assigned to a code.
  • Lack of heating
  • Restriction of space
  • Technical defects in home preventing adequate care
  • Unsatisfactory surroundings

Type 1 Excludes

Type 1 Excludes
A type 1 excludes note is a pure excludes note. It means "NOT CODED HERE!" An Excludes1 note indicates that the code excluded should never be used at the same time as the code above the Excludes1 note. An Excludes1 is used when two conditions cannot occur together, such as a congenital form versus an acquired form of the same condition.
  • problems related to the natural and physical environment Z77.1

Index to Diseases and Injuries

The Index to Diseases and Injuries is an alphabetical listing of medical terms, with each term mapped to one or more ICD-10 code(s). The following references for the code Z59.1 are found in the index:


Code Edits

The Medicare Code Editor (MCE) detects and reports errors in the coding of claims data. The following ICD-10 Code Edits are applicable to this code:

  • Unacceptable principal diagnosis - There are selected codes that describe a circumstance which influences an individual’s health status but not a current illness or injury, or codes that are not specific manifestations but may be due to an underlying cause. These codes are considered unacceptable as a principal diagnosis.

Synonyms

The following clinical terms are approximate synonyms or lay terms that might be used to identify the correct diagnosis code:

  • Access to or within the residence
  • Adequacy of living space - finding
  • Cleanliness of home - finding
  • Crowded living space
  • Damp in house
  • Damp in house
  • Damp in house
  • Damp in house
  • Details of local facilities and amenities - finding
  • Details of local facilities and amenities - finding
  • Difficulty storing food hygienically
  • Dirty home
  • Does not store food hygienically
  • Domestic facilities - finding
  • Environment contains allergens
  • Environment contains infectious agent
  • Environmental foul odor
  • Environmental infestation of insects
  • Finding related to ability to store food hygienically
  • Hazards in the home
  • Home subject to flooding
  • House fumigated
  • House in poor repair
  • House infested
  • House liable to vandalism
  • Housing contains exposed wiring
  • Housing contains structural barriers to movement
  • Housing contains unsafe appliance
  • Housing contains unsafe equipment
  • Housing problem
  • Housing structurally unsound
  • Housing unsuited to needs
  • Improper food storage
  • Inadequate cooking facilities
  • Inadequate exercise space
  • Inadequate garbage disposal
  • Inadequate laundry facilities
  • Inadequate play space
  • Inadequate residential safety device
  • Inadequate safety equipment
  • Inadequate sanitation
  • Inadequate sewage disposal
  • Insufficient means of residential entrance
  • Insufficient means of residential exit
  • Lack of cooling in house
  • Lack of heat in house
  • Lack of running water in house
  • Lack of space for privacy in accommodation
  • Lack of space in house
  • Lives in damp conditions
  • Lives in sheltered housing
  • Lives in squalid conditions
  • Living in housing with technical defects
  • Living in housing without electricity
  • Living in residence with no sanitation
  • Living in residence with poor sanitation
  • Living in tent
  • Local environment and neighborhood details - finding
  • Local environment and neighborhood details - finding
  • No indoor toilet
  • Obstructed means of residential entrance
  • Obstructed means of residential exit
  • Opportunity for privacy in accommodation - finding
  • Overcrowded in house
  • Penetrating damp in home
  • Problem with condensation
  • Rising damp in home
  • Shower or tub on ground level not available
  • Slum housing
  • State of repair of house - finding
  • Unable to store food hygienically
  • Unsafe floor covering
  • Unsafe storage of dangerous objects
  • Unsafe storage of dangerous substances
  • Unsatisfactory living conditions
  • Wet patches on wall in home

Present on Admission (POA)

Z59.1 is exempt from POA reporting - The Present on Admission (POA) indicator is used for diagnosis codes included in claims involving inpatient admissions to general acute care hospitals. POA indicators must be reported to CMS on each claim to facilitate the grouping of diagnoses codes into the proper Diagnostic Related Groups (DRG). CMS publishes a listing of specific diagnosis codes that are exempt from the POA reporting requirement. Review other POA exempt codes here .

CMS POA Indicator Options and Definitions
POA Indicator CodePOA Reason for CodeCMS will pay the CC/MCC DRG?
YDiagnosis was present at time of inpatient admission.YES
NDiagnosis was not present at time of inpatient admission.NO
UDocumentation insufficient to determine if the condition was present at the time of inpatient admission.NO
WClinically undetermined - unable to clinically determine whether the condition was present at the time of inpatient admission.YES
1Unreported/Not used - Exempt from POA reporting. NO

Convert Z59.1 to ICD-9

  • V60.1 - Inadequate housing

Code Classification

  • Factors influencing health status and contact with health services (Z00–Z99)
    • Persons with potential health hazards related to socioeconomic and psychosocial circumstances (Z55-Z65)
      • Problems related to housing and economic circumstances (Z59)

Code History

  • FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016
    (First year ICD-10-CM implemented into the HIPAA code set)
  • FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
  • FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
  • FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
  • FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020