2027 ICD-10-CM Diagnosis Code Z91.81History of falling
Z91.81 is a billable ICD-10-CM diagnosis code for history of falling. 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 at increased risk for falls. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Personal history of other disease.
Code Identity
Code Classification
Code EditsBilling
Medicare Code Editor checks that affect claim validity for Z91.81.
Present on Admission (POA)Billing
Z91.81 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).
Approximate SynonymsGuidance
Alternate terms and clinical phrases that map to this code.
- At increased risk for falls
- At low risk for fall
- At very low risk for fall
- History of fall
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to Z91.81: its own notes plus those printed at Z91, block Z77-Z99, and Chapter 21. A note printed at a category, block or chapter applies to every code under it.
Applicable To
Conditions this code is used for: synonyms of the title or, for "other specified" codes, the conditions assigned to it. The list is not exhaustive.
- At risk for falling
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.
Code Also
A second code may be needed to fully describe the condition; the note gives no sequencing direction.
Notes
General instructions on how these codes are used.
- 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 Z91.81, its category, or a range that includes it.
Excludes2 3
These codes carry an Excludes2 note naming Z91.81: its condition is not part of those codes, and both may be reported when the patient has both.
- R29.6 Repeated fallsat risk for falling (Z91.81)
- R29.6 Repeated fallshistory of falling (Z91.81)
- Block W00-W19 Slipping, tripping, stumbling and fallsat risk for fall (history of fall) Z91.81
Index to Diseases and InjuriesGuidance
Alphabetical index entries that point to this code.
personal (of) See Also: History, family (of);
fall, falling Z91.81
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Patient EducationClinical
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.
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert Z91.81 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About Z91.81Overview
What is the ICD-10 code for history of falling?
The ICD-10-CM code for history of falling is Z91.81 (sometimes written as Z9181). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
Is Z91.81 a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report history of falling on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What MS-DRG does Z91.81 group to?
On inpatient claims, history of falling 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 Z91.81 be a principal diagnosis?
No. The Medicare Code Editor rejects this code as a principal diagnosis because history of falling describes a circumstance that influences health status rather than a current illness. Report it as a secondary diagnosis.
Is Z91.81 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 history of falling 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.
