Z91.198

Z91.198: Patient's noncompliance with other medical treatment and regimen for other reason

Billable / specific codeICD-10-CMPOA exempt

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.

Check Z91.198 with the rest of the claim: free scrubber

Excludes2 inherited from the categories above Z91.198

Not part of this code, but both may be coded when both are present.

Written on Z91.1: Patient's noncompliance with medical treatment and regimen

caregiver noncompliance with patient's medical treatment and regimen (Z91.A-)

Written on Z91: Personal risk factors, not elsewhere classified

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-)
occupational exposure to risk factors (Z57.-)
personal history of physical injury and trauma (Z87.81, Z87.82-)

Risk adjustment

No CMS-HCC V28 category: this code does not change a RAF score.

Medicare coverage

Z91.198 is named in 6 Medicare coverage policies: 6 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.

A54799Billing and Coding: Urine Drug Testing
A55001Billing and Coding: Urine Drug Testing
A56645Billing and Coding: Controlled Substance Monitoring and Drugs of Abuse Testing
A56818Billing and Coding: Urine Drug Testing

Alphabetic index entries that lead here

Nonadherence to medical treatment, specified NEC›due to›specified reason NEC
Noncompliance›with›medical treatment, specified NEC›due to›specified reason NEC

Code history

Unchanged in every release from FY2024 to FY2027.