ICD-10-CM Code Z73.5

Social role conflict, not elsewhere classified

Version 2020 Billable Code Unacceptable Principal Diagnosis POA Exempt

Valid for Submission

Z73.5 is a billable code used to specify a medical diagnosis of social role conflict, not elsewhere classified. The code is valid for the year 2020 for the submission of HIPAA-covered transactions. The ICD-10-CM code Z73.5 might also be used to specify conditions or terms like assumes new role, disturbance in role performance, involuntary role reversal, loses previous role, role change, social role conflict, etc The code is exempt from present on admission (POA) reporting for inpatient admissions to general acute care hospitals.

The code Z73.5 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:Z73.5
Short Description:Social role conflict, not elsewhere classified
Long Description:Social role conflict, not elsewhere classified

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 Z73.5 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:

  • Assumes new role
  • Disturbance in role performance
  • Involuntary role reversal
  • Loses previous role
  • Role change
  • Social role conflict

Present on Admission (POA)

Z73.5 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 Z73.5 to ICD-9

  • V62.4 - Social maladjustment (Approximate Flag)

Code Classification

  • Factors influencing health status and contact with health services (Z00–Z99)
    • Persons encountering health services in other circumstances (Z69-Z76)
      • Problems related to life management difficulty (Z73)

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


Stress

Everyone feels stressed from time to time. Not all stress is bad. All animals have a stress response, and it can be life-saving. But chronic stress can cause both physical and mental harm.

There are at least three different types of stress:

  • Routine stress related to the pressures of work, family, and other daily responsibilities
  • Stress brought about by a sudden negative change, such as losing a job, divorce, or illness
  • Traumatic stress, which happens when you are in danger of being seriously hurt or killed. Examples include a major accident, war, assault, or a natural disaster. This type of stress can cause post-traumatic stress disorder (PTSD).

Different people may feel stress in different ways. Some people experience digestive symptoms. Others may have headaches, sleeplessness, depressed mood, anger, and irritability. People under chronic stress get more frequent and severe viral infections, such as the flu or common cold. Vaccines, such as the flu shot, are less effective for them.

Some people cope with stress more effectively than others. It's important to know your limits when it comes to stress, so you can avoid more serious health effects.

NIH: National Institute of Mental Health


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