2026 ICD-10-CM Diagnosis Code Z91.849Unspecified risk for dental caries

ICD-10-CM Codes›Z00–Z99›Z77-Z99›Z91

ICD-10-CM Z91.849
CMSSource: CMS FY 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

Z91.849 is a billable ICD-10-CM diagnosis code for unspecified risk for dental caries. 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 increased risk for dental caries. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Other specified status.

Code Identity

ICD-10-CM Code
Z91.849
Billable Status
Yes — Valid for Submission
Code Describes
Unspecified risk for dental caries
Short Description
Unspecified risk for dental caries
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 CodeZ91.849Unspecified risk for dental caries

Code EditsBilling

Medicare Code Editor checks that affect claim validity for Z91.849.

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

Z91.849 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 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
    • Risk
      • for
        • dental caries

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

Dental Health

It's important to take care of your mouth and teeth starting in childhood. If you don't, you could have problems with your teeth and gums - like cavities or even tooth loss.

Read the full article at MedlinePlus

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

Convert Z91.849 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 Z91.849 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 Z91.849Overview

Is Z91.849 (Oral health risk factors) a billable code?

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

Can Z91.849 be a principal diagnosis?

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

Is Z91.849 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 unspecified risk for dental caries on inpatient claims.

What is the ICD-9 equivalent of Z91.849?

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