Ophthalmology and Optometry Coding Alert

Question: What is the difference between Z58.81 and Z59.12? We were looking over the new Z codes added in April, and it seems as though they describe the same thing.

Nevada Subscriber

Answer: It may seem like Z58.81 (Basic services unavailable in physical environment) and Z59.12 (Inadequate housing utilities) describe the same thing, but they don’t. Code Z58.81 denotes basic services that are simply unavailable to the patient, either due to an inadequate physical environment or geographic location. For instance, a patient may not be able to obtain internet service due to the remote location in which the patient lives. In comparison, Z59.12 implies a lack of economic resources (e.g., the patient cannot afford to pay for electricity). These two codes can be coded together, per the Excludes2 note under Z59.12 that ICD-10-CM included in the April 2023 updates.