2027 ICD-10-CM Diagnosis Code Z78.1Physical restraint status
Z78.1 is a billable ICD-10-CM diagnosis code for physical restraint status. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 951. 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 handcuffs placed for legal restraint. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Other specified status.
Code Identity
Code Classification
Code EditsBilling
Medicare Code Editor checks that affect claim validity for Z78.1.
Present on Admission (POA)Billing
Z78.1 is exempt from POA reporting on inpatient claims to general acute care hospitals. Review the other POA exempt codes in Persons with potential health hazards related to family and personal history and certain conditions influencing health status (Z77-Z99).
Approximate SynonymsGuidance
Alternate terms and clinical phrases that map to this code.
- Handcuffs placed for legal restraint
- Legal physical restraint performed
- Legal restraint performed by manhandling
- Plastic bindings placed for legal restraint
- Strait jacket placed for legal restraint
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to Z78.1: its own notes plus those printed at Z78, block Z77-Z99, and Chapter 21. A note printed at a category, block or chapter applies to every code under it.
Excludes1
Not coded here: the excluded code is never reported together with this one, unless the two conditions are unrelated.
- physical restraint due to a procedure - omit code
Excludes2
Not included here: the excluded condition is not part of this code, but a patient may have both, so both codes may be reported.
Code Also
A second code may be needed to fully describe the condition; the note gives no sequencing direction.
Notes
General instructions on how these codes are used.
- Z codes represent reasons for encounters. A corresponding procedure code must accompany a Z code if a procedure is performed. Categories Z00-Z99 are provided for occasions when circumstances other than a disease, injury or external cause classifiable to categories A00-Y89 are recorded as 'diagnoses' or 'problems'. This can arise in two main ways:
- (a) When a person who may or may not be sick encounters the health services for some specific purpose, such as to receive limited care or service for a current condition, to donate an organ or tissue, to receive prophylactic vaccination (immunization), or to discuss a problem which is in itself not a disease or injury.
- (b) When some circumstance or problem is present which influences the person's health status but is not in itself a current illness or injury.
Source: CMS ICD-10-CM Tabular List. How to read instructional notes.
Index to Diseases and InjuriesGuidance
Alphabetical index entries that point to this code.
Status (post) See Also: Presence (of);
physical restraint Z78.1
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Convert Z78.1 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About Z78.1Overview
What is the ICD-10 code for physical restraint status?
The ICD-10-CM code for physical restraint status is Z78.1 (sometimes written as Z781). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
Is Z78.1 (Other specified health status) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report physical restraint status on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What MS-DRG does Z78.1 group to?
On inpatient claims, physical restraint status maps to MS-DRG 951 (other Factors Influencing Health Status), which carries a relative weight of 0.5574. Higher weights mean higher Medicare reimbursement.
Can Z78.1 be a principal diagnosis?
No. The Medicare Code Editor rejects this code as a principal diagnosis because physical restraint status describes a circumstance that influences health status rather than a current illness. Report it as a secondary diagnosis.
Is Z78.1 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 physical restraint status on inpatient claims. The code appears in the Persons with potential health hazards related to family and personal history and certain conditions influencing health status (Z77-Z99) range of the CMS exempt list.
