ICD-10-CM Code Z91.81

History of falling

Version 2020 Billable Code Unacceptable Principal Diagnosis POA Exempt

Valid for Submission

Z91.81 is a billable code used to specify a medical diagnosis of history of falling. The code is valid for the year 2020 for the submission of HIPAA-covered transactions. The ICD-10-CM code Z91.81 might also be used to specify conditions or terms like at low risk for fall or at risk for falls or at very low risk for fall or history of fall. The code is exempt from present on admission (POA) reporting for inpatient admissions to general acute care hospitals.

The code Z91.81 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:Z91.81
Short Description:History of falling
Long Description:History of falling

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 Z91.81:

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.
  • At risk for falling

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 Z91.81 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:

  • At low risk for fall
  • At risk for falls
  • At very low risk for fall
  • History of fall

Present on Admission (POA)

Z91.81 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 Z91.81 to ICD-9

  • V15.88 - Personal history of fall

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


Falls

Falls can be dangerous at any age. Babies and young children can get hurt falling off furniture or down the stairs. Older children may fall off playground equipment. For older adults, falls can be especially serious. They are at higher risk of falling. They are also more likely to break a bone when they fall, especially if they have osteoporosis. A broken bone, especially when it is a hip, may even lead to disability and a loss of independence for older adults.

Some common causes of falls include

  • Balance problems
  • Some medicines, which can make you feel dizzy, confused, or slow
  • Vision problems
  • Alcohol, which can affect your balance and reflexes
  • Muscle weakness, especially in your legs, which can make it harder for you to get up from a chair or keep your balance when walking on an uneven surface.
  • Certain illnesses, such as low blood pressure, diabetes, and neuropathy
  • Slow reflexes, which make it hard to keep your balance or move out of the way of a hazard
  • Tripping or slipping due to loss of footing or traction

At any age, people can make changes to lower their risk of falling. It important to take care of your health, including getting regular eye exams. Regular exercise may lower your risk of falls by strengthening your muscles, improving your balance, and keeping your bones strong. And you can look for ways to make your house safer. For example, you can get rid of tripping hazards and make sure that you have rails on the stairs and in the bath. To reduce the chances of breaking a bone if you do fall, make sure that you get enough calcium and vitamin D.

NIH: National Institute on Aging


[Learn More]