ICD-10 Z76.5
Billable / SpecificMalingerer [conscious simulation]
About ICD-10-CM Z76.5
ICD-10-CM code Z76.5 represents Malingerer [conscious simulation]. This is a billable/specific code in the Factors Influencing Health Status chapter (block Z76). The 2026 edition of ICD-10-CM Z76.5 became effective on October 1, 2025.
Inclusion Terms / Approximate Synonyms
Clinical terms and conditions classified under Z76.5. Per CMS ICD-10-CM Tabular 2026.
- Person feigning illness (with obvious motivation)
Type 1 Excludes
Pure excludes, these codes can never be coded together with Z76.5. The conditions are mutually exclusive (e.g., congenital vs acquired forms).
- factitious disorder (F68.1-, F68.A)
- peregrinating patient (F68.1-)
Medicare LCD Coverage for Z76.5
Local Coverage Determinations (LCDs) from CMS MACs that list Z76.5 as a covered diagnosis.
Showing top 10 of 43 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing Z76.5.
3 Medicare
CPT Codes Commonly Billed with Z76.5
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.
Convert Z76.5 to ICD-9-CM
Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.
| ICD-10 | ICD-9 | Mapping Flags |
|---|---|---|
| Z76.5 | V652 | 00000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To Z76.5
Other codes in section Z69-Z76 (Persons encountering health services in other circumstances).
ICD-10 Z76.5, Billing FAQ
Is ICD-10 code Z76.5 billable? +
Yes, Z76.5 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.
What other names or terms map to Z76.5? +
ICD-10 Z76.5 includes: Person feigning illness (with obvious motivation).
What codes are Type 1 Excludes for Z76.5? +
Type 1 Excludes (never code together with Z76.5): factitious disorder (F68.1-, F68.A); peregrinating patient (F68.1-)
What ICD-9 codes does Z76.5 map to? +
Per CMS GEMs, Z76.5 maps to ICD-9 codes: V652. Useful for legacy data review and historical claim analysis.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on July 16, 2026.
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