Z91.198 — Patient's noncompliance with other medical treatment and regimen for other reason
Z91.198 is a billable, specific ICD-10-CM code for patient's noncompliance with other medical treatment and regimen for other reason. It is valid for submission on a claim.
Risk adjustment
Z91.198 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
Z91.198 is named in 7 Medicare coverage policies — 7 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A54799Billing and Coding: Urine Drug Testing
- A55001Billing and Coding: Urine Drug Testing
- A56645Billing and Coding: Controlled Substance Monitoring and Drugs of Abuse Testing
- A56645Billing and Coding: Controlled Substance Monitoring and Drugs of Abuse Testing
How Z91.198 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 Z91.198.
- Nonadherence to medical treatment, specified NEC›due to›specified reason NEC
- Noncompliance›with›medical treatment, specified NEC›due to›specified reason NEC
Related codes at this level
Codes that share Z91.19. If Z91.198 is not quite right, the correct code is usually one of these.
Questions about Z91.198
- Is Z91.198 a billable ICD-10-CM code?
- Yes. Z91.198 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does Z91.198 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 family and personal history and certain conditions influencing health status (Z77-Z99).