2024 ICD-10-CM Diagnosis Code Z91.199
Patient's noncompliance with other medical treatment and regimen due to unspecified reason
- ICD-10-CM Code:
- Z91.199
- ICD-10 Code for:
- Pt noncompl with other med trtmt and regimen d/t unsp reason
- Is Billable?
- Yes - Valid for Submission
- Code Navigator:
Z91.199 is a billable diagnosis code used to specify a medical diagnosis of patient's noncompliance with other medical treatment and regimen due to unspecified reason. The code is valid during the current fiscal year for the submission of HIPAA-covered transactions from October 01, 2023 through September 30, 2024. The code is exempt from present on admission (POA) reporting for inpatient admissions to general acute care hospitals.
This code 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.
Unspecified diagnosis codes like Z91.199 are acceptable when clinical information is unknown or not available about a particular condition. Although a more specific code is preferable, unspecified codes should be used when such codes most accurately reflect what is known about a patient's condition. Specific diagnosis codes should not be used if not supported by the patient's medical record.
Approximate Synonyms
The following clinical terms are approximate synonyms or lay terms that might be used to identify the correct diagnosis code:
- Asthma treatment compliance unsatisfactory
- Chronic disease - uncooperative patient
- Compliance with footwear - finding
- Diabetic-uncooperative patient
- Did not attend hypertension clinic
- Did not wait for treatment
- Difficulty complying with treatment
- Finding related to ability to comply with treatment
- Finding related to ability to comply with treatment
- Noncompliance in general
- Noncompliance with dental treatment
- Noncompliance with diagnostic testing
- Noncompliance with exercise regimen
- Noncompliance with fluid volume management
- Noncompliance with immunization regimen
- Noncompliance with infection control regimen
- Noncompliance with safety precautions
- Noncompliance with self-monitoring regimen
- Noncompliance with therapeutic regimen
- Noncompliance with treatment
- Patient noncompliance - general
- Patient non-compliant - declined intervention / support
- Patient non-compliant with footwear
- Patient non-compliant with specific advice
- Safety behavior observation
- Unable to comply with treatment
Clinical Classification
Clinical Category is Other specified status
- CCSR Category Code: FAC025
- Inpatient Default CCSR: X - Not applicable.
- Outpatient Default CCSR: Y - Yes, default outpatient assignment for principal diagnosis or first-listed diagnosis.
Index to Diseases and Injuries References
The following annotation back-references for this diagnosis code are found in the injuries and diseases index. The Index to Diseases and Injuries is an alphabetical listing of medical terms, with each term mapped to one or more ICD-10-CM code(s).
- - Nonadherence to medical treatment, specified NEC - Z91.199
- - Noncompliance - Z91.199
- - with
- - medical treatment, specified NEC - Z91.199
- - with
Code Edits
The Medicare Code Editor (MCE) detects and reports errors in the coding of claims data. The following ICD-10-CM 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.
Present on Admission (POA)
Z91.199 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 | 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 |
Replacement Code
Z91199 replaces the following previously assigned ICD-10-CM code(s):
- Z91.19 - Patient's noncompliance w oth medical treatment and regimen
Code History
- FY 2024 - No Change, effective from 10/1/2023 through 9/30/2024
- FY 2023 - Code Added, effective from 10/1/2022 through 9/30/2023