ICD-10-CM Code Z91.849

Unspecified risk for dental caries

Version 2020 Billable Code Unacceptable Principal Diagnosis POA Exempt

Valid for Submission

Z91.849 is a billable code used to specify a medical diagnosis of unspecified risk for dental caries. The code is valid for the year 2020 for the submission of HIPAA-covered transactions. The ICD-10-CM code Z91.849 might also be used to specify conditions or terms like at risk for dental caries. The code is exempt from present on admission (POA) reporting for inpatient admissions to general acute care hospitals.

The code Z91.849 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:Z91.849
Short Description:Unspecified risk for dental caries
Long Description:Unspecified risk for dental caries

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 Z91.849 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 risk for dental caries

Present on Admission (POA)

Z91.849 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

Replacement Code

Z91849 replaces the following previously assigned ICD-10 code(s):

  • Z91.89 - Oth personal risk factors, not elsewhere classified

Convert Z91.849 to ICD-9

  • V15.89 - Hx-health hazards 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 2018 - Code Added, 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