ICD-10-CM Code Z63.72

Alcoholism and drug addiction in family

Version 2020 Billable Code Unacceptable Principal Diagnosis POA Exempt

Valid for Submission

Z63.72 is a billable code used to specify a medical diagnosis of alcoholism and drug addiction in family. The code is valid for the year 2020 for the submission of HIPAA-covered transactions. The ICD-10-CM code Z63.72 might also be used to specify conditions or terms like alcohol misuser in household, alcoholic family member, alcoholic family syndrome, alcoholic parent, alcoholic spouse, alteration in family processes, etc The code is exempt from present on admission (POA) reporting for inpatient admissions to general acute care hospitals.

The code Z63.72 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:Z63.72
Short Description:Alcoholism and drug addiction in family
Long Description:Alcoholism and drug addiction in family

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 Z63.72 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:

  • Alcohol misuser in household
  • Alcoholic family member
  • Alcoholic family syndrome
  • Alcoholic parent
  • Alcoholic spouse
  • Alteration in family processes
  • Alteration in family processes
  • Alteration in family processes
  • Dysfunctional family due to alcoholism
  • Husband alcoholic

Present on Admission (POA)

Z63.72 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 Z63.72 to ICD-9

  • V61.41 - Alcoholism in family (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


Alcohol Use Disorder (AUD)

For most adults, moderate alcohol use is probably not harmful. However, about 18 million adult Americans have an alcohol use disorder (AUD). This means that their drinking causes distress and harm. It includes alcoholism and alcohol abuse.

Alcoholism, or alcohol dependence, is a disease that causes

  • Craving - a strong need to drink
  • Loss of control - not being able to stop drinking once you've started
  • Physical dependence - withdrawal symptoms
  • Tolerance - the need to drink more alcohol to feel the same effect

With alcohol abuse, you are not physically dependent, but you still have a serious problem. The drinking may cause problems at home, work, or school. It may cause you to put yourself in dangerous situations, or lead to legal or social problems.

Another common problem is binge drinking. It is drinking about five or more drinks in two hours for men. For women, it is about four or more drinks in two hours.

Too much alcohol is dangerous. Heavy drinking can increase the risk of certain cancers. It can cause damage to the liver, brain, and other organs. Drinking during pregnancy can harm your baby. Alcohol also increases the risk of death from car crashes, injuries, homicide, and suicide.

You may have an AUD if you can answer yes to two or more of these questions:

In the past year, have you

  • Ended up drinking more or for a longer time than you had planned to?
  • Wanted to cut down or stop drinking, or tried to, but couldn't?
  • Spent a lot of your time drinking, or recovering from drinking?
  • Felt a strong need to drink?
  • Found that drinking - or being sick from drinking - often interfered with your family life, job, or school?
  • Kept drinking even though it was causing trouble with your family or friends?
  • Given up or cut back on activities that you enjoyed just so you could drink?
  • Gotten into dangerous situations while drinking or after drinking? Some examples are driving drunk and having unsafe sex.
  • Kept drinking even though it was making you feel depressed or anxious? Or when it was adding to another health problem?
  • Had to drink more and more to feel the effects of the alcohol?
  • Had withdrawal symptoms when the alcohol was wearing off? They include trouble sleeping, shakiness, irritability, anxiety, depression, restlessness, nausea, and sweating. In severe cases, you could have a fever, seizures, or hallucinations.

If you have any of these symptoms, your drinking may already be a cause for concern. The more symptoms you have, the more serious the problem is. If you think you might have an AUD, see your health care provider for an evaluation. Your provider can help make a treatment plan, prescribe medicines, and if needed, give you treatment referrals.

NIH: National Institute on Alcohol Abuse and Alcoholism


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Drug Use and Addiction

Drug abuse is a serious public health problem that affects almost every community and family in some way. Each year drug abuse causes millions of serious illnesses or injuries among Americans. Abused drugs include

  • Methamphetamine
  • Anabolic steroids
  • Club drugs
  • Cocaine
  • Heroin
  • Inhalants
  • Marijuana
  • Prescription drugs, including opioids

Drug abuse also plays a role in many major social problems, such as drugged driving, violence, stress, and child abuse. Drug abuse can lead to homelessness, crime, and missed work or problems with keeping a job. It harms unborn babies and destroys families. There are different types of treatment for drug abuse. But the best is to prevent drug abuse in the first place.

NIH: National Institute on Drug Abuse


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Family Issues

There are many kinds of families. Some have two parents, while others have a single parent. Sometimes there is no parent and grandparents raise grandchildren. Some children live in foster families, adoptive families, or in stepfamilies.

Families are much more than groups of people who share the same genes or the same address. They should be a source of love and support. This does not mean that everyone gets along all the time. Conflicts are a part of family life. Many things can lead to conflict, such as illness, disability, addiction, job loss, school problems, and marital issues. Listening to each other and working to resolve conflicts are important in strengthening the family.


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