ICD-10-CM Code Z91.5

Personal history of self-harm

Version 2020 Billable Code Unacceptable Principal Diagnosis POA Exempt

Valid for Submission

Z91.5 is a billable code used to specify a medical diagnosis of personal history of self-harm. The code is valid for the year 2020 for the submission of HIPAA-covered transactions. The ICD-10-CM code Z91.5 might also be used to specify conditions or terms like artefactual skin disease, at risk of self-injurious behavior, biting own arm, biting own fingers, biting own hand, biting own toes, etc The code is exempt from present on admission (POA) reporting for inpatient admissions to general acute care hospitals.

The code Z91.5 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:Z91.5
Short Description:Personal history of self-harm
Long Description:Personal history of self-harm

Tabular List of Diseases and Injuries

The Tabular List of Diseases and Injuries is a list of ICD-10 codes, organized "head to toe" into chapters and sections with guidance for inclusions, exclusions, descriptions and more. The following references are applicable to the code Z91.5:

Inclusion Terms

Inclusion Terms
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.
  • Personal history of parasuicide
  • Personal history of self-poisoning
  • Personal history of suicide attempt

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 Z91.5 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:

  • Artefactual skin disease
  • At risk of self-injurious behavior
  • Biting own arm
  • Biting own fingers
  • Biting own hand
  • Biting own toes
  • Biting own tongue
  • Biting self
  • Breaking own bones
  • Burning self
  • Caustic burn of skin
  • Cutting own throat
  • Cutting own wrists
  • Cutting self
  • Damaging own wounds
  • Drowning self
  • Eating own flesh
  • Enucleation of own eyes
  • Factitious skin disease
  • Found hanging self
  • Gouging own body parts
  • Gouging own eyes
  • Gouging own flesh
  • Gouging own rectum
  • Gouging own vagina
  • H/O: attempted suicide
  • H/O: deliberate self harm
  • Hanging self
  • Head-hitting
  • Hitting self
  • Inserting foreign bodies into own orifices
  • Inserting objects into wound
  • Jumping from bridge
  • Jumping from building
  • Jumping from cliff
  • Jumping from height
  • Nipping self
  • Picking own skin
  • Pinching self
  • Poking fingers into wound
  • Previous known suicide attempt
  • Pulling out sutures
  • Pulling own teeth out
  • Punching self
  • Removing own nails
  • Reopening scars
  • Rubbing own skin
  • Scratches self
  • Self abuse
  • Self-electrocution
  • Self-incineration
  • Self-induced disease
  • Self-inducing a prolapse
  • Self-inflicted caustic burn
  • Self-inflicted skin problems
  • Self-mutilation
  • Self-mutilation of ears
  • Self-mutilation of eyes
  • Self-mutilation of genitalia
  • Self-mutilation of hands
  • Self-mutilation of penis
  • Self-scalding
  • Shooting self
  • Slapping self
  • Stabbing self
  • Stripping own skin
  • Swallowing objects
  • Swallowing substances
  • Throwing self in front of train
  • Throwing self in front of vehicle
  • Throwing self onto floor

Present on Admission (POA)

Z91.5 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 Z91.5 to ICD-9

  • V15.59 - Hx injury NEC (Approximate Flag)

Code Classification

  • Factors influencing health status and contact with health services (Z00–Z99)
    • Persons with potential health hazards related to family and personal history and certain conditions influencing health status (Z77-Z99)
      • Personal risk factors, not elsewhere classified (Z91)

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


Self-Harm

What is self-harm?

Self-harm, or self-injury, is when a person hurts his or her own body on purpose. The injuries may be minor, but sometimes they can be severe. They may leave permanent scars or cause serious health problems. Some examples are

  • Cutting yourself (such as using a razor blade, knife, or other sharp object to cut your skin)
  • Punching yourself or punching things (like a wall)
  • Burning yourself with cigarettes, matches, or candles
  • Pulling out your hair
  • Poking objects through body openings
  • Breaking your bones or bruising yourself

Self-harm is not a mental disorder. It is a behavior - an unhealthy way to cope with strong feelings. However, some of the people who harm themselves do have a mental disorder.

People who harm themselves are usually not trying to kill themselves. But they are at higher risk of attempting suicide if they do not get help.

Why do people harm themselves?

There are different reasons why people harm themselves. Often, they have trouble coping and dealing with their feelings. They harm themselves to try to

  • Make themselves feel something, when they feel empty or numb inside
  • Block upsetting memories
  • Show that they need help
  • Release strong feelings that overwhelm them, such as anger, loneliness, or hopelessness
  • Punish themselves
  • Feel a sense of control

Who is at risk for self-harm?

There are people of all ages who harm themselves, but it usually starts in the teen or early adult years. Self-harm is more common in people who

  • Were abused or went through a trauma as children
  • Have mental disorders, such as
    • Depression
    • Eating disorders
    • Post-traumatic stress disorder
    • Certain personality disorders
  • Abuse drugs or alcohol
  • Have friends who self-harm
  • Have low self-esteem

What are the signs of self-harm?

Signs that someone may be hurting themselves include

  • Having frequent cuts, bruises, or scars
  • Wearing long sleeves or pants even in hot weather
  • Making excuses about injuries
  • Having sharp objects around for no clear reason

How can I help someone who self-harms?

If someone you know is self-harming, it is important not to be judgmental. Let that person know that you want to help. If the person is a child or teenager, ask him or her to talk to a trusted adult. If he or she won't do that, talk to a trusted adult yourself. If the person who is self-harming is an adult, suggest mental health counseling.

What the treatments are for self-harm?

There are no medicines to treat self-harming behaviors. But there are medicines to treat any mental disorders that the person may have, such as anxiety and depression. Treating the mental disorder may weaken the urge to self-harm.

Mental health counseling or therapy can also help by teaching the person

  • Problem-solving skills
  • New ways to cope with strong emotions
  • Better relationship skills
  • Ways to strengthen self-esteem

If the problem is severe, the person may need more intensive treatment in a psychiatric hospital or a mental health day program.


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