Z60.4 — Social exclusion and rejection
Z60.4 is a billable, specific ICD-10-CM code for social exclusion and rejection. It is valid for submission on a claim.
Excludes1 — 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
These codes carry an Excludes1 note pointing at Z60.4. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading Z60.4 alone.
- Z60.5Target of (perceived) adverse discrimination and persecution
Risk adjustment
Z60.4 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.
Medicare coverage
Z60.4 is named in 1 Medicare coverage policy — 1 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A57130Billing and Coding: Psychiatric Codes
How Z60.4 is indexed
Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to Z60.4.
- 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
Related codes at this level
Codes that share Z60. If Z60.4 is not quite right, the correct code is usually one of these.
Questions about Z60.4
- Is Z60.4 a billable ICD-10-CM code?
- Yes. Z60.4 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does Z60.4 sit in the tabular list?
- Factors influencing health status and contact with health services (Z00-Z99), in the block Persons with potential health hazards related to socioeconomic and psychosocial circumstances (Z55-Z65).
- What cannot be coded together with Z60.4?
- Z60.4 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.