2027 ICD-10-CM Diagnosis Code Z59.11Inadequate housing environmental temperature

ICD-10-CM Codes›Z00–Z99›Z55-Z65›Z59

ICD-10-CM Z59.11
CMSSource: CMS FY 2027 ICD-10-CM dataset · Effective Oct 1, 2026 – Sep 30, 2027

Z59.11 is a billable ICD-10-CM diagnosis code for inadequate housing environmental temperature. 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. Coders also document this condition as housing unsuited to needs. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Socioeconomic/psychosocial factors.

Code Identity

ICD-10-CM Code
Z59.11
Billable Status
Yes — Valid for Submission
Code Describes
Inadequate housing environmental temperature
Short Description
Inadequate housing environmental temperature
Same as the full description in the CMS dataset.
Parent Code
Z59.1
Inadequate housing

Code Classification

ChapterZ00–Z99Factors influencing health status and contact with health services
SectionZ55-Z65Persons with potential health hazards related to socioeconomic and psychosocial circumstances
CategoryZ59Problems related to housing and economic circumstances
This CodeZ59.11Inadequate housing environmental temperature

Code EditsBilling

Medicare Code Editor checks that affect claim validity for Z59.11.

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.

Present on Admission (POA)Billing

Z59.11 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).

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Housing unsuited to needs
  • Lack of cooling in house
  • Lack of heat in house
  • No heating facilities in residence

Instructional NotesGuidance

Instructions from the official ICD-10-CM Tabular List that apply to Z59.11: its own notes plus those printed at Z59.1, Z59, 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.

  • Lack of air conditioning
  • Lack of heating

Excludes2

Not included here: the excluded condition is not part of this code, but a patient may have both, so both codes may be reported.

From Z59.1 Inadequate housing applies to 4 codes
  • problems related to the natural and physical environment (Z77.1-)
From Z59 Problems related to housing and economic circumstances applies to 25 codes
  • problems related to upbringing (Z62.-)

Notes

General instructions on how these codes are used.

From Chapter 21 (Z00-Z99) Factors influencing health status and contact with health services applies to 1,425 codes
  • 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.

Referenced in Other NotesGuidance

Instructional notes printed at other codes that name Z59.11, its category, or a range that includes it.

Excludes2 2

These codes carry an Excludes2 note naming Z59.11: its condition is not part of those codes, and both may be reported when the patient has both.

  • Z56 Problems related to employment and unemployment
    problems related to housing and economic circumstances (Z59.-) names Z59.-, which includes this code
  • Z62 Problems related to upbringing
    problems related to housing and economic circumstances (Z59.-) names Z59.-, which includes this code

Index to Diseases and InjuriesGuidance

Alphabetical index entries that point to this code.

Clinical ClassificationClinical

AHRQ’s CCSR groups this code into broader clinical categories.

CCSR FAC019
Socioeconomic/psychosocial factors
Default principal diagnosis: inpatient No · outpatient No

Code History & ChangesHistory

Replacement Z59.11 replaces the following previously assigned code(s):

  • Z59.1 - Inadequate housing
FY 2024AddedAdded to the ICD-10-CM code setEffective October 1, 2023.
FY 2025–2026No changes
FY 2027CurrentCurrent code set, no changesEffective October 1, 2026 through September 30, 2027.

Questions About Z59.11Overview

What is the ICD-10 code for inadequate housing environmental temperature?

The ICD-10-CM code for inadequate housing environmental temperature is Z59.11 (sometimes written as Z5911). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

Is Z59.11 (Inadequate housing) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report inadequate housing environmental temperature on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

What MS-DRG does Z59.11 group to?

On inpatient claims, inadequate housing environmental temperature 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 Z59.11 be a principal diagnosis?

No. The Medicare Code Editor rejects this code as a principal diagnosis because inadequate housing environmental temperature describes a circumstance that influences health status rather than a current illness. Report it as a secondary diagnosis.

Is Z59.11 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 inadequate housing environmental temperature 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.