ICD-10-CM Code Z65.3

Problems related to other legal circumstances

Version 2020 Billable Code Unacceptable Principal Diagnosis POA Exempt

Valid for Submission

Z65.3 is a billable code used to specify a medical diagnosis of problems related to other legal circumstances. The code is valid for the year 2020 for the submission of HIPAA-covered transactions. The ICD-10-CM code Z65.3 might also be used to specify conditions or terms like access to child - finding, access to child - finding, acquitted from criminal charge, affairs in jurisdiction of court of protection, affairs under jurisdiction of a court, arrested by police, etc The code is exempt from present on admission (POA) reporting for inpatient admissions to general acute care hospitals.

The code Z65.3 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:Z65.3
Short Description:Problems related to other legal circumstances
Long Description:Problems related to other legal circumstances

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 Z65.3:

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.
  • Arrest
  • Child custody or support proceedings
  • Litigation
  • Prosecution

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 Z65.3 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 child - finding
  • Access to child - finding
  • Acquitted from criminal charge
  • Affairs in jurisdiction of court of protection
  • Affairs under jurisdiction of a court
  • Arrested by police
  • Arrested in police custody
  • Breakdown of child placement
  • Cautioned by police
  • Charged with crime
  • Charged with drunk driving offence
  • Child access refused
  • Child access revoked
  • Child in police protection
  • Child on remand
  • Child protection finding
  • Child protection finding
  • Compensation claim pending
  • Convicted of drunk driving
  • Court case pending
  • Eligibility for criminal injuries compensation - finding
  • Eligible for criminal injuries compensation
  • Forged or altered prescription
  • Has a criminal record
  • Has a prison record
  • In police custody
  • Involved in civil law proceedings
  • Involved in criminal activity
  • Involved in criminal law proceedings
  • Involved in legal proceedings
  • Involved with police
  • Legal affairs and legal constraints - finding
  • Legal insurance problem
  • Legal problem
  • Legal problem with divorce
  • Legal problem with separation
  • Legal prosecution
  • Litigation
  • Litigation pending
  • Litigation underway
  • Lost custody of children
  • Medicolegal procedure status
  • On conditional probation
  • On probation
  • On remand
  • Pleads guilty
  • Pleads not guilty
  • Police investigation
  • Prosecution impending
  • Released on bail
  • Statement made to police
  • Subpoenaed for attendance in court
  • Vandalism record
  • Young offender

Present on Admission (POA)

Z65.3 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 Z65.3 to ICD-9

  • V62.5 - Legal circumstances (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)
      • Problems related to other psychosocial circumstances (Z65)

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