2017/18 ICD-10-CM Diagnosis Code Z91.13

Patient's unintentional underdosing of medication regimen

Code First
Code First Help
Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. For such conditions, ICD-10-CM has a coding convention that requires the underlying condition be sequenced first followed by the manifestation. Wherever such a combination exists there is a "use additional code" note at the etiology code, and a "code first" note at the manifestation code. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. In most cases the manifestation codes will have in the code title, "in diseases classified elsewhere." Codes with this title are a component of the etiology/manifestation convention. The code title indicates that it is a manifestation code. "In diseases classified elsewhere" codes are never permitted to be used as first listed or principle diagnosis codes. They must be used in conjunction with an underlying condition code and they must be listed following the underlying condition.
  • underdosing of medication (T36-T50
    ICD-10-CM Range T36-T50

    Poisoning by, adverse effect of and underdosing of drugs, medicaments and biological substances

    Code First
    • , for adverse effects, the nature of the adverse effect, such as:
    • adverse effect NOS (T88.7 )
    • aspirin gastritis (K29.-)
    • blood disorders (D56-D76 )
    • contact dermatitis (L23-L25 )
    • dermatitis due to substances taken internally (L27.-)
    • nephropathy (N14.0-N14.2)
    Includes
    • adverse effect of correct substance properly administered
    • poisoning by overdose of substance
    • poisoning by wrong substance given or taken in error
    • underdosing by (inadvertently) (deliberately) taking less substance than prescribed or instructed
    Note
    • The drug giving rise to the adverse effect should be identified by use of codes from categories T36-T50 with fifth or sixth character 5.
    Type 1 Excludes
    • toxic reaction to local anesthesia in pregnancy (O29.3-)
    Type 2 Excludes
    • abuse and dependence of psychoactive substances (F10-F19)
    • abuse of non-dependence-producing substances (F55.-)
    • drug reaction and poisoning affecting newborn (P00-P96)
    • pathological drug intoxication (inebriation) (F10-F19)
    Use Additional
    • code(s) to specify:
    • manifestations of poisoning
    • underdosing or failure in dosage during medical and surgical care (Y63.6, Y63.8-Y63.9)
    • underdosing of medication regimen (Z91.12-, Z91.13-)
    • T36 Poisoning by, adverse effect of and unde...
    • T37 Poisoning by, adverse effect of and unde...
    • T38 Poisoning by, adverse effect of and unde...
    • T39 Poisoning by, adverse effect of and unde...
    • T40 Poisoning by, adverse effect of and unde...
    • T41 Poisoning by, adverse effect of and unde...
    • T42 Poisoning by, adverse effect of and unde...
    • T43 Poisoning by, adverse effect of and unde...
    • T44 Poisoning by, adverse effect of and unde...
    • T45 Poisoning by, adverse effect of and unde...
    • T46 Poisoning by, adverse effect of and unde...
    • T47 Poisoning by, adverse effect of and unde...
    • T48 Poisoning by, adverse effect of and unde...
    • T49 Poisoning by, adverse effect of and unde...
    • T50 Poisoning by, adverse effect of and unde...
    ) with fifth or sixth character 6
Type 1 Excludes
Type 1 Excludes Help
A type 1 excludes note is a pure excludes. It means "not coded here". A type 1 excludes note indicates that the code excluded should never be used at the same time as Z91.13. A type 1 excludes note is for used for when two conditions cannot occur together, such as a congenital form versus an acquired form of the same condition.
  • adverse effect of prescribed drug taken as directed- code to adverse effect
  • poisoning (overdose) -code to poisoning
The following code(s) above Z91.13 contain annotation back-references
Annotation Back-References
In this context, annotation back-references refer to codes that contain:
  • Applicable To annotations, or
  • Code Also annotations, or
  • Code First annotations, or
  • Excludes1 annotations, or
  • Excludes2 annotations, or
  • Includes annotations, or
  • Note annotations, or
  • Use Additional annotations
that may be applicable to Z91.13:
  • Z00-Z99
    2018 ICD-10-CM Range Z00-Z99

    Factors influencing health status and contact with health services

    Note
    • Z codes represent reasons for encounters. A corresponding procedure code must accompany a Z code if a procedure is performed. Categories Z00-Z99 are provided for occasions when circumstances other than a disease, injury or external cause classifiable to categories A00-Y89 are recorded as 'diagnoses' or 'problems'. This can arise in two main ways:
    • (a) When a person who may or may not be sick encounters the health services for some specific purpose, such as to receive limited care or service for a current condition, to donate an organ or tissue, to receive prophylactic vaccination (immunization), or to discuss a problem which is in itself not a disease or injury.
    • (b) When some circumstance or problem is present which influences the person's health status but is not in itself a current illness or injury.
    Factors influencing health status and contact with health services
  • Z77-Z99
    2018 ICD-10-CM Range Z77-Z99

    Persons with potential health hazards related to family and personal history and certain conditions influencing health status

    Code Also
    • any follow-up examination (Z08-Z09)
    Persons with potential health hazards related to family and personal history and certain conditions influencing health status
  • Z91
    ICD-10-CM Diagnosis Code Z91

    Personal risk factors, not elsewhere classified

      2016 2017 2018 Non-Billable/Non-Specific Code
    Type 2 Excludes
    • contact with and (suspected) exposures hazardous to health (Z77.-)
    • exposure to pollution and other problems related to physical environment (Z77.1-)
    • female genital mutilation status (N90.81-)
    • personal history of physical injury and trauma (Z87.81, Z87.82-)
    • occupational exposure to risk factors (Z57.-)
    Personal risk factors, not elsewhere classified
Code History
ICD-10-CM Codes Adjacent To Z91.13
Z91.04 Nonmedicinal substance allergy status
Z91.040 Latex allergy status
Z91.041 Radiographic dye allergy status
Z91.048 Other nonmedicinal substance allergy status
Z91.09 Other allergy status, other than to drugs and biological substances
Z91.1 Patient's noncompliance with medical treatment and regimen
Z91.11 Patient's noncompliance with dietary regimen
Z91.12 Patient's intentional underdosing of medication regimen
Z91.120 …… due to financial hardship
Z91.128 …… for other reason
Z91.13 Patient's unintentional underdosing of medication regimen
Z91.130 …… due to age-related debility
Z91.138 …… for other reason
Z91.14 Patient's other noncompliance with medication regimen
Z91.15 Patient's noncompliance with renal dialysis
Z91.19 Patient's noncompliance with other medical treatment and regimen
Z91.4 Personal history of psychological trauma, not elsewhere classified
Z91.41 Personal history of adult abuse
Z91.410 Personal history of adult physical and sexual abuse
Z91.411 Personal history of adult psychological abuse
Z91.412 Personal history of adult neglect

Reimbursement claims with a date of service on or after October 1, 2015 require the use of ICD-10-CM codes.