ICD-10 Z69.1
Non-Billable HeaderEncounter for mental health services for spousal or partner abuse problems
About ICD-10-CM Z69.1
ICD-10-CM code Z69.1 represents Encounter for mental health services for spousal or partner abuse problems. This is a non-billable header code in the Factors Influencing Health Status chapter (block Z69). The 2026 edition of ICD-10-CM Z69.1 became effective on October 1, 2025. Non-billable codes cannot be used as a primary or secondary diagnosis on a claim, use a more specific child code instead.
Medicare LCD Coverage for Z69.1
Local Coverage Determinations (LCDs) from CMS MACs that list Z69.1 as a covered diagnosis.
This doesn't mean the code isn't covered, it means no MAC has issued a Local Coverage Determination naming this specific code. Coverage may still apply under National Coverage Determinations or general medical-necessity rules.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing Z69.1.
Our payer policy database covers Aetna, Cigna, Anthem, BCBS, Humana, and Medicare Advantage plans, but Z69.1 doesn't currently appear in any indexed policy. The code may still be covered under standard plan benefits.
CPT Codes Commonly Billed with Z69.1
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
We don't have CPT pairings indexed for this specific code yet. Use the CPT search above to find common procedures, or check your payer's published medical policy for code-specific guidance.
Codes Adjacent To Z69.1
Other codes in section Z69-Z76 (Persons encountering health services in other circumstances).
ICD-10 Z69.1, Billing FAQ
Is ICD-10 code Z69.1 billable? +
No, Z69.1 is a non-billable header code. Use a more specific child code from block Z69 when submitting claims.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
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