2027 ICD-10-CM Diagnosis Code Z91.158Patient's noncompliance with renal dialysis for other reason

ICD-10-CM Codes›Z00–Z99›Z77-Z99›Z91

ICD-10-CM Z91.158
CMSSource: CMS FY 2027 ICD-10-CM dataset · Effective Oct 1, 2026 – Sep 30, 2027

Z91.158 is a billable ICD-10-CM diagnosis code for Patient's noncompliance with renal dialysis for other reason. 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 difficulty managing peritoneal dialysis. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Other specified status.

Z91.158 no longer risk-adjusts for Medicare Advantage: it mapped to HCC 134 under the retired CMS-HCC V24 model through payment year 2025 but maps to no category in the live V28 model. It still risk-adjusts in the PACE (CMS-HCC V22) category 134, ESRD (V21) category 134, ESRD (V24) category 134, and RxHCC Part D (V08) category 261 for payment year 2027.

Code Identity

ICD-10-CM Code
Z91.158
Billable Status
Yes — Valid for Submission
Code Describes
Patient's noncompliance with renal dialysis for other reason
Short Description
Patient's noncompliance with renal dialysis for other reason
Same as the full description in the CMS dataset.
Parent Code
Z91.15
Patient's noncompliance with renal dialysis

Code Classification

ChapterZ00–Z99Factors influencing health status and contact with health services
SectionZ77-Z99Persons with potential health hazards related to family and personal history and certain conditions influencing health status
CategoryZ91Personal risk factors, not elsewhere classified
This CodeZ91.158Patient's noncompliance with renal dialysis for other reason

Code EditsBilling

Medicare Code Editor checks that affect claim validity for Z91.158.

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)Billing

Z91.158 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).

Medicare Risk Adjustment (HCC)Billing

Z91.158 no longer risk-adjusts for Medicare Advantage: it maps to no payment category in the live CMS-HCC V28 model, although it still risk-adjusts in the other CMS models shown below.

CMS-HCC V28 (Medicare Advantage Payment Model)
Not mapped
Dropped in V28 see all codes that no longer risk-adjust
Prior Model (CMS-HCC V24)
HCC 134
V24 retired last contributed to a Medicare Advantage risk score in payment year 2025
Other CMS Models
PACE (CMS-HCC V22): HCC 134 · ESRD (V21): HCC 134 · ESRD (V24): HCC 134
ESRD V21 weights: 0.000 dialysis, 0.000 functioning graft · ESRD V24 weights: 0.000 dialysis, 0.000 functioning graft
Part D (RxHCC)
RxHCC 261 — Dialysis Status, Including End Stage Renal Disease
also risk-adjusts in the Part D prescription drug model (V08)

Source: CMS Payment Year 2027 risk adjustment mappings and model software. Weights are relative factors, not dollar amounts; a beneficiary's total RAF also includes demographics and interactions. Browse all CMS-HCC categories.

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Difficulty managing peritoneal dialysis
  • Non-compliance with collection of peritoneal dialysate specimen
  • Non-compliance with renal dialysis
  • Non-compliant with peritoneal dialysis prescription

Instructional NotesGuidance

Instructions from the official ICD-10-CM Tabular List that apply to Z91.158: its own notes plus those printed at Z91.1, Z91, block Z77-Z99, and Chapter 21. A note printed at a category, block or chapter applies to every code under it.

Excludes2

Not included here: the excluded condition is not part of this code, but a patient may have both, so both codes may be reported.

From Z91.1 Patient's noncompliance with medical treatment and regimen applies to 14 codes
  • caregiver noncompliance with patient's medical treatment and regimen (Z91.A-)
From Z91 Personal risk factors, not elsewhere classified applies to 62 codes
  • contact with and (suspected) exposures hazardous to health (Z77.-)
  • exposure to pollution and other problems related to physical environment (Z77.1-)
  • female genital mutilation status (N90.81-)
  • occupational exposure to risk factors (Z57.-)
  • personal history of physical injury and trauma (Z87.81, Z87.82-)

Code Also

A second code may be needed to fully describe the condition; the note gives no sequencing direction.

From Z91.1 Patient's noncompliance with medical treatment and regimen applies to 14 codes
  • if applicable, to identify underdosing of specific drug (T36-T50 with final character 6)
From Block Z77-Z99 Persons with potential health hazards related to family and personal history and certain conditions influencing health status applies to 567 codes
  • any follow-up examination (Z08-Z09)

Notes

General instructions on how these codes are used.

From Chapter 21 (Z00-Z99) Factors influencing health status and contact with health services applies to 1,425 codes
  • 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 Z91.158, its category, or a range that includes it.

Excludes2 1

These codes carry an Excludes2 note naming Z91.158: its condition is not part of those codes, and both may be reported when the patient has both.

  • Z99.2 Dependence on renal dialysis
    noncompliance with renal dialysis (Z91.15-) names Z91.15-, which includes this code

Index to Diseases and InjuriesGuidance

Alphabetical index entries that point to this code.

Clinical ClassificationClinical

AHRQ’s CCSR groups this code into broader clinical categories.

CCSR FAC025
Other specified status
Default principal diagnosis: inpatient No · outpatient Yes

Code History & ChangesHistory

Replacement Z91.158 replaces the following previously assigned code(s):

  • Z91.15 - Patient's noncompliance with renal dialysis
FY 2024AddedAdded to the ICD-10-CM code setEffective October 1, 2023.
FY 2025–2026No changes
FY 2027CurrentCurrent code set, no changesEffective October 1, 2026 through September 30, 2027.

Questions About Z91.158Overview

What is the ICD-10 code for Patient's noncompliance with renal dialysis for other reason?

The ICD-10-CM code for Patient's noncompliance with renal dialysis for other reason is Z91.158 (sometimes written as Z91158). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

Is Z91.158 (Patient's noncompliance with renal dialysis) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report Patient's noncompliance with renal dialysis for other reason on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

What MS-DRG does Z91.158 group to?

On inpatient claims, Patient's noncompliance with renal dialysis for other reason 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 Z91.158 be a principal diagnosis?

No. The Medicare Code Editor rejects this code as a principal diagnosis because Patient's noncompliance with renal dialysis for other reason describes a circumstance that influences health status rather than a current illness. Report it as a secondary diagnosis.

Is Z91.158 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 Patient's noncompliance with renal dialysis for other reason 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.

Does Z91.158 risk-adjust for Medicare Advantage payment?

Not for Medicare Advantage. Z91.158 mapped to HCC 134 in the retired CMS-HCC V24 model, which last determined payment in 2025, but it maps to no category in the live V28 model; see all codes that no longer risk-adjust. It still risk-adjusts in the PACE (CMS-HCC V22) category 134 (Dialysis Status), ESRD (V21) category 134 (Dialysis Status), ESRD (V24) category 134 (Dialysis Status), and RxHCC Part D (V08) category 261 (Dialysis Status, Including End Stage Renal Disease).