ICD-10 Z91.1
Non-Billable HeaderPatient's noncompliance with medical treatment and regimen
About ICD-10-CM Z91.1
ICD-10-CM code Z91.1 represents Patient's noncompliance with medical treatment and regimen. This is a non-billable header code in the Factors Influencing Health Status chapter (block Z91). The 2026 edition of ICD-10-CM Z91.1 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.
Type 2 Excludes
Not included here, the excluded code is not part of Z91.1, but a patient may have both conditions at the same time. Both codes may be coded together when applicable.
- caregiver noncompliance with patient's medical treatment and regimen (Z91.A-)
Coding Notes
Code Also
- , if applicable, to identify underdosing of specific drug (T36-T50 with final character 6)
Medicare LCD Coverage for Z91.1
Local Coverage Determinations (LCDs) from CMS MACs that list Z91.1 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 Z91.1.
Our payer policy database covers Aetna, Cigna, Anthem, BCBS, Humana, and Medicare Advantage plans, but Z91.1 doesn't currently appear in any indexed policy. The code may still be covered under standard plan benefits.
CPT Codes Commonly Billed with Z91.1
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 Z91.1
Other codes in section Z77-Z99 (Persons with potential health hazards related to family and personal history and certain conditions influencing health status).
ICD-10 Z91.1, Billing FAQ
Is ICD-10 code Z91.1 billable? +
No, Z91.1 is a non-billable header code. Use a more specific child code from block Z91 when submitting claims.
What codes are Type 2 Excludes for Z91.1? +
Type 2 Excludes (may be coded together when both conditions exist): caregiver noncompliance with patient's medical treatment and regimen (Z91.A-)
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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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