Z60.4
Z60.4: Social exclusion and rejection
Billable / specific codeICD-10-CM
Z60.4 is a billable, specific ICD-10-CM code for social exclusion and rejection. It is valid for submission on a claim.
Check Z60.4 with the rest of the claim: free scrubberExcludes1: never code together
These conditions cannot occur together. Billing both on the same encounter is a denial.
- target of adverse discrimination such as for racial or religious reasons (Z60.5)
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Exclusion and rejection on the basis of personal characteristics, such as unusual physical appearance, illness or behavior.
- Social isolation
Other codes that can never be billed with Z60.4
Their own Excludes1 notes name this code, so the conflict is not listed above.
- Z60.5Target of (perceived) adverse discrimination and persecution
Risk adjustment
No CMS-HCC V28 category: this code does not change a RAF score.
Medicare coverage
Z60.4 is named in 1 Medicare coverage policy: 1 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- A57130Billing and Coding: Psychiatric Codes
Alphabetic index entries that lead here
- Deprivation›social
- Isolation, isolated›social
- Social›exclusion
- Social›rejection
- Problem›social›exclusion and rejection
- Maladjustment›social›due to›exclusion and isolation
- Maladjustment›social›due to›rejection
Code history
Unchanged in every release from FY2024 to FY2027.