2022 ICD-10-CM Code Z72.6
Gambling and betting
Code Classification
Z72.6 is a billable diagnosis code used to specify a medical diagnosis of gambling and betting. The code Z72.6 is valid during the fiscal year 2022 from October 01, 2021 through September 30, 2022 for the submission of HIPAA-covered transactions.
The ICD-10-CM code Z72.6 might also be used to specify conditions or terms like gambling. The code is exempt from present on admission (POA) reporting for inpatient admissions to general acute care hospitals.
The code Z72.6 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.
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 coding notes and guidance for inclusions, exclusions, descriptions and more. The following references are applicable to the code Z72.6:
Type 1 Excludes
Type 1 ExcludesA type 1 excludes note is a pure excludes note. It means "NOT CODED HERE!" An Excludes1 note indicates that the code excluded should never be used at the same time as the code above the Excludes1 note. An Excludes1 is used when two conditions cannot occur together, such as a congenital form versus an acquired form of the same condition.
- compulsive or pathological gambling F63.0
Entries in the Index to Diseases and Injuries with references to Z72.6
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 Z72.6 are found in the index:
- - Betting and gambling - Z72.6
- - Gambling - Z72.6
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.
Approximate Synonyms
The following clinical terms are approximate synonyms or lay terms that might be used to identify the correct diagnosis code:
- Gambling
Present on Admission (POA)
Z72.6 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 Code | POA Reason for Code | CMS will pay the CC/MCC DRG? |
|---|---|---|
| Y | Diagnosis was present at time of inpatient admission. | YES |
| N | Diagnosis was not present at time of inpatient admission. | NO |
| U | Documentation insufficient to determine if the condition was present at the time of inpatient admission. | NO |
| W | Clinically undetermined - unable to clinically determine whether the condition was present at the time of inpatient admission. | YES |
| 1 | Unreported/Not used - Exempt from POA reporting. | NO |
Convert Z72.6 to ICD-9 Code
- V69.3 - Gambling and betting
Information for Patients
Compulsive Gambling
Many people enjoy gambling, whether it's betting on a horse or playing poker on the Internet. Most people who gamble don't have a problem, but some lose control of their gambling. Signs of problem gambling include
- Always thinking about gambling
- Lying about gambling
- Spending work or family time gambling
- Feeling bad after you gamble, but not quitting
- Gambling with money you need for other things
If you have concerns about your gambling, ask for help. Your health care provider can work with you to find the treatment that's best for you.
NIH: National Institutes of Health
[Learn More in MedlinePlus]
Related Codes
| ICD Code | Description | Valid for Submission |
|---|---|---|
| Z72 | Problems related to lifestyle | NON-BILLABLE CODE |
| Z72.0 | Tobacco use | BILLABLE CODE |
| Z72.3 | Lack of physical exercise | BILLABLE CODE |
| Z72.4 | Inappropriate diet and eating habits | BILLABLE CODE |
| Z72.5 | High risk sexual behavior | NON-BILLABLE CODE |
| Z72.51 | High risk heterosexual behavior | BILLABLE CODE |
| Z72.52 | High risk homosexual behavior | BILLABLE CODE |
| Z72.53 | High risk bisexual behavior | BILLABLE CODE |
| Z72.8 | Other problems related to lifestyle | NON-BILLABLE CODE |
| Z72.81 | Antisocial behavior | NON-BILLABLE CODE |
| Z72.810 | Child and adolescent antisocial behavior | BILLABLE CODE |
| Z72.811 | Adult antisocial behavior | BILLABLE CODE |
| Z72.82 | Problems related to sleep | NON-BILLABLE CODE |
| Z72.820 | Sleep deprivation | BILLABLE CODE |
| Z72.821 | Inadequate sleep hygiene | BILLABLE CODE |
| Z72.89 | Other problems related to lifestyle | BILLABLE CODE |
| Z72.9 | Problem related to lifestyle, unspecified | BILLABLE CODE |
Code History
- FY 2021 - No Change, effective from 10/1/2020 through 9/30/2021
- FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020
- FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
- FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
- FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
- FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016 (First year ICD-10-CM implemented into the HIPAA code set)
