ICD-10-CM Code Z63.5

Disruption of family by separation and divorce

Version 2020 Billable Code Unacceptable Principal Diagnosis POA Exempt

Valid for Submission

Z63.5 is a billable code used to specify a medical diagnosis of disruption of family by separation and divorce. The code is valid for the year 2020 for the submission of HIPAA-covered transactions. The ICD-10-CM code Z63.5 might also be used to specify conditions or terms like broken with partner, divorce, divorce problems, divorce proceedings pending, divorced, family disruption due to divorce, etc The code is exempt from present on admission (POA) reporting for inpatient admissions to general acute care hospitals.

The code Z63.5 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:Z63.5
Short Description:Disruption of family by separation and divorce
Long Description:Disruption of family by separation and divorce

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 Z63.5:

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.
  • Marital estrangement

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 Z63.5 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:

  • Broken with partner
  • Divorce
  • Divorce problems
  • Divorce proceedings pending
  • Divorced
  • Family disruption due to divorce
  • Family disruption due to legal separation
  • Family disruption with separation
  • Husband left home
  • Legally separated with interlocutory decree
  • Maladjustment to married life
  • Marital problems
  • Marital status of parents
  • Marriage annulment
  • Parents separated
  • Separated
  • Separated from cohabitee
  • Separation
  • Single person
  • Spouse left home
  • Trial separation
  • Wife left home

Present on Admission (POA)

Z63.5 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 Z63.5 to ICD-9

  • V61.03 - Fmily dsrpt- divorce/sep (Approximate Flag)

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)
      • Oth prob rel to prim support group, inc family circumstances (Z63)

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

Information for Patients


Divorce

Divorce is the legal breakup of a marriage. Like every major life change, divorce is stressful. It affects finances, living arrangements, household jobs, schedules, and more. If the family includes children, they may be deeply affected.


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