2026 ICD-10-CM Diagnosis Code Z76.5Malingerer [conscious simulation]
Z76.5 is a billable ICD-10-CM diagnosis code for malingerer [conscious simulation]. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026) and groups to MS-DRG 951. The code is exempt from POA reporting. Coders also document this condition as drug seeking behavior. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Other specified status.
Code Identity
Code Classification
Present on Admission (POA)Billing
Z76.5 is exempt from POA reporting on inpatient claims to general acute care hospitals. Review the other POA exempt codes in Persons encountering health services in other circumstances (Z69-Z76).
Approximate SynonymsGuidance
Alternate terms and clinical phrases that map to this code.
- Drug seeking behavior
- Feigning of symptoms
- Malingering
Tabular List NotesGuidance
Coding notes and annotation back-references applicable to this code.
Inclusion Terms
- Person feigning illness (with obvious motivation)
Type 1 Excludes
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.
A 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.
Index to Diseases and InjuriesGuidance
Alphabetical index entries that point to this code.
drug seeking Z76.5
Disorder (of) See Also: Disease;
Feigned illness Z76.5
Malingerer, malingering Z76.5
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Clinical InformationClinical
Malingering
simulation of symptoms of illness or injury with intent to deceive in order to obtain a goal, e.g., a claim of physical illness to avoid jury duty.
Patient EducationClinical
Mental Disorders
Mental disorders (or mental illnesses) are conditions that affect your thinking, feeling, mood, and behavior. They may happen over a short period of time or come and go. Some can be chronic (long-lasting). They can affect your ability to relate to others and function each day..
The full article covers:
- What are mental disorders?
- What are some types of mental disorders?
- What causes mental disorders?
- Who is at risk for mental disorders?
- How are mental disorders diagnosed?
- What are the treatments for mental disorders?
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert Z76.5 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About Z76.5Overview
What is the ICD-10 code for malingerer [conscious simulation]?
The ICD-10-CM code for malingerer [conscious simulation] is Z76.5 (sometimes written as Z765). It is billable on HIPAA-covered claims from October 1, 2025 through September 30, 2026.
Is Z76.5 (Persons encountering health services in other circumstances) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report malingerer [conscious simulation] on HIPAA-covered claims from October 1, 2025 through September 30, 2026.
What MS-DRG does Z76.5 group to?
When malingerer [conscious simulation] is the principal diagnosis on an inpatient stay, it groups to MS-DRG 951 (other Factors Influencing Health Status), which carries a relative weight of 0.556. Higher weights mean higher Medicare reimbursement.
Is Z76.5 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 malingerer [conscious simulation] on inpatient claims. The code appears in the Persons encountering health services in other circumstances (Z69-Z76) range of the CMS exempt list.
What is the ICD-9 equivalent of Z76.5?
Under the General Equivalence Mappings, malingerer [conscious simulation] converts to ICD-9-CM V65.2 (person feigning illness). The mapping is a direct match.
