2026 ICD-10-CM Diagnosis Code Z91.198Patient's noncompliance with other medical treatment and regimen for other reason

ICD-10-CM Codes›Z00–Z99›Z77-Z99›Z91

ICD-10-CM Z91.198
CMSSource: CMS FY 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

Z91.198 is a billable ICD-10-CM diagnosis code for Patient's noncompliance with other medical treatment and regimen for other reason. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026). 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 exercise regime. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Other specified status.

Code Identity

ICD-10-CM Code
Z91.198
Billable Status
Yes — Valid for Submission
Code Describes
Patient's noncompliance with other medical treatment and regimen for other reason
Short Description
Pt noncompl with other med trtmt and regimen for other rsn
Parent Code
Z91.19
Patient's noncompliance with other medical treatment and regimen

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 CodeZ91.198Patient's noncompliance with other medical treatment and regimen for other reason

Code EditsBilling

Medicare Code Editor checks that affect claim validity for Z91.198.

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

Z91.198 is exempt from POA reporting on inpatient claims to general acute care hospitals. Review other POA exempt codes.

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Difficulty managing exercise regime
  • Problem with high complexity of treatment regime

Index to Diseases and InjuriesGuidance

Alphabetical index entries that point to this code.

External Cause of Injuries IndexGuidance

References for this code in the External Cause of Injuries Index.

    • Nonadherence to medical treatment, specified NEC
      • due to
        • specified reason NEC
    • Noncompliance
      • with
        • medical treatment, specified NEC
          • due to
            • specified reason NEC

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 Z91.198 replaces the following previously assigned code(s):

  • Z91.19 - Patient's noncompliance w oth medical treatment and regimen
FY 2023AddedAdded to the ICD-10-CM code setEffective October 1, 2022.
FY 2024–2025No changes
FY 2026CurrentCurrent code set, no changesEffective October 1, 2025 through September 30, 2026.

Questions About Z91.198Overview

Is Z91.198 a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report Patient's noncompliance with other medical treatment and regimen for other reason on HIPAA-covered claims from October 1, 2025 through September 30, 2026.

Can Z91.198 be a principal diagnosis?

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

Is Z91.198 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 other medical treatment and regimen for other reason on inpatient claims.