2026 ICD-10-CM Diagnosis Code Z64.4Discord with counselors

ICD-10-CM Codes›Z00–Z99›Z55-Z65›Z64

ICD-10-CM Z64.4
CMSSource: CMS FY 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

Z64.4 is a billable ICD-10-CM diagnosis code for discord with counselors. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026). 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 discord with counselor. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Socioeconomic/psychosocial factors.

Code Identity

ICD-10-CM Code
Z64.4
Billable Status
Yes — Valid for Submission
Code Describes
Discord with counselors
Short Description
Discord with counselors
Same as the full description in the CMS dataset.
Parent Code
Z64
Problems related to certain psychosocial circumstances

Code Classification

ChapterZ00–Z99Factors influencing health status and contact with health services
SectionZ55-Z65Persons with potential health hazards related to socioeconomic and psychosocial circumstances
CategoryZ64Problems related to certain psychosocial circumstances
This CodeZ64.4Discord with counselors

Code EditsBilling

Medicare Code Editor checks that affect claim validity for Z64.4.

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

Z64.4 is exempt from POA reporting on inpatient claims to general acute care hospitals. Review other POA exempt codes.

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Discord with counselor
  • Discord with probation officer
  • Discord with social worker

Tabular List NotesGuidance

Coding notes and annotation back-references applicable to this code.

Inclusion Terms

  • Discord with probation officer
  • Discord with social worker

Index to Diseases and InjuriesGuidance

Alphabetical index entries that point to this code.

External Cause of Injuries IndexGuidance

References for this code in the External Cause of Injuries Index.

    • Discord(with)
      • counselor
    • Discord(with)
      • probation officer
    • Discord(with)
      • social worker
    • Problem(with) (related to)
      • conflict or discord (with)
        • counselor
    • Problem(with) (related to)
      • conflict or discord (with)
        • probation officer
    • Problem(with) (related to)
      • conflict or discord (with)
        • social worker
    • Problem(with) (related to)
      • counselor
    • Problem(with) (related to)
      • probation officer
    • Problem(with) (related to)
      • social
        • worker

Clinical ClassificationClinical

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

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

Convert Z64.4 to ICD-9-CMHistory

The closest ICD-9-CM equivalents under the General Equivalence Mappings.

ICD-9-CM
V62.89 Psychological stress NEC
Approximate The match is approximate rather than exact.

Code HistoryHistory

FY 2016AddedAdded to the ICD-10-CM code setEffective October 1, 2015, the first year of ICD-10-CM.
FY 2017–2025No changes
FY 2026CurrentCurrent code set, no changesEffective October 1, 2025 through September 30, 2026.

Questions About Z64.4Overview

Is Z64.4 (Problems related to certain psychosocial circumstances) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report discord with counselors on HIPAA-covered claims from October 1, 2025 through September 30, 2026.

Can Z64.4 be a principal diagnosis?

No. The Medicare Code Editor rejects this code as a principal diagnosis because discord with counselors describes a circumstance that influences health status rather than a current illness. Report it as a secondary diagnosis.

Is Z64.4 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 discord with counselors on inpatient claims.

What is the ICD-9 equivalent of Z64.4?

Under the General Equivalence Mappings, discord with counselors converts to ICD-9-CM V62.89 (psychological stress NEC). The mapping is approximate, so confirm the match fits the documentation.