Wiki Z91 Noncompliant Diagnosis Code and Z59 Homelessness Dx Code

Create Wiki Sort by votes
T

TThivierge

True Blue
Messages
1,074
Location
Atlanta, GA
Best answers
0
Hi
I know the Z91 block of diagnosis codes give reasons why patients are noncompliant in not following the clinical providers orders. The patient could not follow due to refusing take medications given, or not follow a diet plan, or refuse to agree to the medical plan given or suggestion to improve the patient s health. I know we use this as the last dx code on the claim and have seen physician list it under his or her assessments of the final treatment diagnosis. But I am wondering will this eventually affect the patient's coverage with their insurance payer? Or is it just a tracking their care over the year?

At this time we have homeless due to many reasons. I know our hospital uses the Homelessness dx code Z59 for some indigent or very ill patients now lacking a home or living in shelter. But don t you feel the insurance companies want to know the reason why the patient is homeless? Or a definitive or symptom dx code plus supporting documentation for the reason a patient is in a homeless situation? I believe that dx Z59 should not be listed as first dx code. What do you other coder's think?
Lady T
 
Last edited:
1
Z codes, in general, are supposed to be used as secondary codes. The only time a Z code would be primary is if it is an Encounter-for code, such as Z00.00.
 
1
ramyareddy8790@gmail.com said:
what if the patient's only complaint is sheltered homelessness and there are no other complaints. In this case can we take z59.01 as a primary diagnosis? any thoughts on this
Click to expand...
If that is all you have in the documentation, then that's what you'd have to use. There's no coding guideline saying this code can't be primary, although there's no guarantee that some payers won't deny it for this.

I would recommend reviewing the documentation though - if the patient is seeking assistance due to a problem related to housing, another code in Z59.1- to Z59.3, or an observation code in the Z03-Z04 range, or even Z71.1 - Person with feared health complaint in whom no diagnosis is made - may be more appropriate to describe the encounter.
 
0
If a medical reason the patient is being seen for is listed, that's what we code. A patient would not be seen by a medical provider solely due to their living situation, rather they would have a medical condition that may coincide with being homeless (ex, hypothermia).
 
Last edited:
You must log in or register to reply here.
Top