Z77-Z99 — Persons with potential health hazards related to family and personal history and certain conditions influencing health status
ICD-10-CM codes Z77-Z99 cover persons with potential health hazards related to family and personal history and certain conditions influencing health status, within factors influencing health status and contact with health services. The block holds 739 codes across 23 categories, of which 554 are billable and 185 are header codes that cannot be submitted on a claim.
Risk adjustment in Z77-Z99
0 codes in this block map to a CMS-HCC, which means the diagnosis carries a risk-adjustment payment when it is documented and coded. Under-coding here is money left on the table; over-coding here is what audits are for.
- HCC 409 Amputation Status, Lower Limb/Amputation Complications
- HCC 463 Artificial Openings for Feeding or Elimination
- HCC 211 Respirator Dependence/Tracheostomy Status/Complications
- HCC 221 Heart Transplant Status/Complications
- HCC 223 Heart Assist Device/Artificial Heart
- HCC 276 Lung Transplant Status/Complications
What else to watch in Z77-Z99
- 54 codes are laterality-specific. They come in left and right pairs, and the pair is mutually exclusive on a single site: coding both without a bilateral code is a contradiction a scrubber should catch before the payer does.
- 380 codes are named in Medicare coverage policies. An LCD or NCD lists them as supporting medical necessity, or explicitly as not supporting it. Which applies depends on the MAC for your state.
Categories in Z77-Z99
- Z77Other contact with and (suspected) exposures hazardous to health
- Z78Other specified health status
- Z79Long term (current) drug therapy
- Z80Family history of primary malignant neoplasm
- Z81Family history of mental and behavioral disorders
- Z82Family history of certain disabilities and chronic diseases (leading to disablement)
- Z83Family history of other specific disorders
- Z84Family history of other conditions
- Z85Personal history of malignant neoplasm
- Z86Personal history of certain other diseases
- Z87Personal history of other diseases and conditions
- Z88Allergy status to drugs, medicaments and biological substances
- Z89Acquired absence of limb
- Z90Acquired absence of organs, not elsewhere classified
- Z91Personal risk factors, not elsewhere classified
- Z92Personal history of medical treatment
- Z93Artificial opening status
- Z94Transplanted organ and tissue status
- Z95Presence of cardiac and vascular implants and grafts
- Z96Presence of other functional implants
- Z97Presence of other devices
- Z98Other postprocedural states
- Z99Dependence on enabling machines and devices, not elsewhere classified