2026 ICD-10-CM Diagnosis Code Z91.843Risk for dental caries, high

ICD-10-CM Codes›Z00–Z99›Z77-Z99›Z91

ICD-10-CM Z91.843
CMSSource: CMS FY 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

Z91.843 is a billable ICD-10-CM diagnosis code for risk for dental caries, high. 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 at extreme risk for dental caries. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Other specified status.

Code Identity

ICD-10-CM Code
Z91.843
Billable Status
Yes — Valid for Submission
Code Describes
Risk for dental caries, high
Short Description
Risk for dental caries, high
Same as the full description in the CMS dataset.
Parent Code
Z91.84
Oral health risk factors

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 CodeZ91.843Risk for dental caries, high

Code EditsBilling

Medicare Code Editor checks that affect claim validity for Z91.843.

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

Z91.843 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.

  • At extreme risk for dental caries
  • At high risk for dental caries
  • At increased risk for dental caries

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.

    • At risk
      • for
        • dental caries
          • high
    • Risk
      • for
        • dental caries
          • high

Clinical ClassificationClinical

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

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

Patient EducationClinical

Tooth Decay

Tooth decay is damage to a tooth's surface, or enamel. It happens when bacteria in your mouth make acids that attack the enamel. Tooth decay can lead to cavities (dental caries), which are holes in your teeth. If tooth decay is not treated, it can cause pain, infection, and even tooth loss.

The full article covers:

  • What is tooth decay?
  • What causes tooth decay?
  • Who is at risk for tooth decay?
  • What are the symptoms of tooth decay and cavities?
  • How are tooth decay and cavities diagnosed?
  • What are the treatments for tooth decay and cavities?
  • Can tooth decay be prevented?

Read the full article at MedlinePlus

Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.

Convert Z91.843 to ICD-9-CMHistory

The closest ICD-9-CM equivalents under the General Equivalence Mappings.

ICD-9-CM
V15.89 Hx-health hazards NEC
Approximate The match is approximate rather than exact.

Code History & ChangesHistory

Replacement Z91.843 replaces the following previously assigned code(s):

  • Z91.89 - Oth personal risk factors, not elsewhere classified
FY 2018AddedAdded to the ICD-10-CM code setEffective October 1, 2017.
FY 2019–2025No changes
FY 2026CurrentCurrent code set, no changesEffective October 1, 2025 through September 30, 2026.

Questions About Z91.843Overview

Is Z91.843 (Oral health risk factors) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report risk for dental caries, high on HIPAA-covered claims from October 1, 2025 through September 30, 2026.

Can Z91.843 be a principal diagnosis?

No. The Medicare Code Editor rejects this code as a principal diagnosis because risk for dental caries, high describes a circumstance that influences health status rather than a current illness. Report it as a secondary diagnosis.

Is Z91.843 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 risk for dental caries, high on inpatient claims.

What is the ICD-9 equivalent of Z91.843?

Under the General Equivalence Mappings, risk for dental caries, high converts to ICD-9-CM V15.89 (hx-health hazards NEC). The mapping is approximate, so confirm the match fits the documentation.