2027 ICD-10-CM Diagnosis Code Z81.1Family history of alcohol abuse and dependence
Z81.1 is a billable ICD-10-CM diagnosis code for family history of alcohol abuse and dependence. 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 family history of alcoholism. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Family history of disease.
Code Identity
Code Classification
Code EditsBilling
Medicare Code Editor checks that affect claim validity for Z81.1.
Present on Admission (POA)Billing
Z81.1 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.
- Family history of alcoholism
- Family history of harmful pattern of substance use
- Father has harmful pattern of alcohol use
- H/O - maternal psychiatric problem
- Maternal substance abuse
- Mother has harmful pattern of alcohol use
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to Z81.1: its own notes plus those printed at block Z77-Z99 and Chapter 21. A note printed at a category, block or chapter applies to every code under it.
Applicable To
Conditions this code is used for: synonyms of the title or, for "other specified" codes, the conditions assigned to it. The list is not exhaustive.
- Conditions classifiable to F10.-
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.
Referenced in Other NotesGuidance
Instructional notes printed at other codes that name Z81.1, its category, or a range that includes it.
Use Additional Code 1
These codes say to use an additional code from the note, and Z81.1 is one of the codes named.
- Z15 Genetic susceptibility to disease
Index to Diseases and InjuriesGuidance
Alphabetical index entries that point to this code.
family (of) See Also: History, personal (of);
alcohol abuse Z81.1
alcohol Z81.1
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Patient EducationClinical
Alcohol Use Disorder (AUD)
For most adults, moderate alcohol use is probably not harmful. Your risk of developing an alcohol use disorder (AUD) depends on how much, how often, and how quickly you drink alcohol. Alcohol misuse means that drinking causes distress and harm. Over time alcohol misuse can increase your risk of AUD.
The full article covers:
- What is alcohol use disorder (AUD)?
- What is binge drinking?
- What are the dangers of too much alcohol?
- How do I know if I have an alcohol use disorder (AUD)?
- What should I do if I think that I might have an alcohol use disorder (AUD)?
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert Z81.1 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About Z81.1Overview
What is the ICD-10 code for family history of alcohol abuse and dependence?
The ICD-10-CM code for family history of alcohol abuse and dependence is Z81.1 (sometimes written as Z811). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
Is Z81.1 (Family history of mental and behavioral disorders) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report family history of alcohol abuse and dependence on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What MS-DRG does Z81.1 group to?
On inpatient claims, family history of alcohol abuse and dependence 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 Z81.1 be a principal diagnosis?
No. The Medicare Code Editor rejects this code as a principal diagnosis because family history of alcohol abuse and dependence describes a circumstance that influences health status rather than a current illness. Report it as a secondary diagnosis.
Is Z81.1 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 family history of alcohol abuse and dependence 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.
