ICD-10-CM 2026 · Effective October 1, 2025

ICD-10 Z91.A58

Billable / Specific HCC v28: 134

Caregiver's noncompliance with patient's renal dialysis for other reason

Z91
Block
0
Synonyms
33
LCDs
4
Payer Policies
0
Linked CPTs

About ICD-10-CM Z91.A58

ICD-10-CM code Z91.A58 represents Caregiver's noncompliance with patient's renal dialysis for other reason. This is a billable/specific code in the Factors Influencing Health Status chapter (block Z91). The 2026 edition of ICD-10-CM Z91.A58 became effective on October 1, 2025.

Coding Tips for Z91.A58

Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.

HCC capture: document with MEAT each year

Z91.A58 is a CMS-HCC v28 risk-adjustment code (category 134). To count for the patient Risk Adjustment Factor (RAF), document the diagnosis with MEAT language each calendar year: Monitored, Evaluated, Assessed, Treated. A diagnosis on the problem list alone does not satisfy CMS RADV audit standards. Include the diagnosis in the assessment with current status and current treatment plan.

Medicare Advantage HCC Impact

CMS-HCC v28 (current)
Category 134
ESRD-HCC
Category 134
RxHCC (Part D)
Category 134

Capture this diagnosis annually for accurate risk adjustment. Missed HCC captures are the #1 revenue leak in Medicare Advantage risk programs.

Medicare LCD Coverage for Z91.A58

Local Coverage Determinations (LCDs) from CMS MACs that list Z91.A58 as a covered diagnosis.

33 LCDs

Showing top 10 of 33 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Urine Drug Testing
Article ID: 59416, Effective: 2025-11-01 00:00:00, 428 covered, 0 non-covered
CPT G0480 →
CMS LCD: Billing and Coding: Urine Drug Testing
Article ID: 59416, Effective: 2025-11-01 00:00:00, 428 covered, 0 non-covered
CPT G0481 →
CMS LCD: Billing and Coding: Urine Drug Testing
Article ID: 59416, Effective: 2025-11-01 00:00:00, 428 covered, 0 non-covered
CPT G0482 →
CMS LCD: Billing and Coding: Urine Drug Testing
Article ID: 59416, Effective: 2025-11-01 00:00:00, 428 covered, 0 non-covered
CPT G0483 →
CMS LCD: Billing and Coding: Urine Drug Testing
Article ID: 59416, Effective: 2025-11-01 00:00:00, 428 covered, 0 non-covered
CPT 80305 →
CMS LCD: Billing and Coding: Urine Drug Testing
Article ID: 59416, Effective: 2025-11-01 00:00:00, 428 covered, 0 non-covered
CPT G0659 →
CMS LCD: Billing and Coding: Urine Drug Testing
Article ID: 59416, Effective: 2025-11-01 00:00:00, 428 covered, 0 non-covered
CPT 80307 →
CMS LCD: Billing and Coding: Urine Drug Testing
Article ID: 59416, Effective: 2025-11-01 00:00:00, 428 covered, 0 non-covered
CPT 80306 →
CMS LCD: Billing and Coding: Urine Drug Testing
Article ID: 55001, Effective: 2026-01-01 00:00:00, 388 covered, 0 non-covered
CPT G0480 →
CMS LCD: Billing and Coding: Urine Drug Testing
Article ID: 55001, Effective: 2026-01-01 00:00:00, 388 covered, 0 non-covered
CPT G0481 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing Z91.A58.

4 policies

4 Medicare

Billing and Coding: Urine Drug Testing
Policy ID: ART-54799
Billing and Coding: Urine Drug Testing
Policy ID: ART-55001
Billing and Coding: Urine Drug Testing
Policy ID: ART-56818
Billing and Coding: Urine Drug Testing
Policy ID: ART-59416

CPT Codes Commonly Billed with Z91.A58

Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.

No procedure linkages on file for Z91.A58

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.A58

Other codes in section Z77-Z99 (Persons with potential health hazards related to family and personal history and certain conditions influencing health status).

Z77 Other contact with and (suspected) exposures hazardous to health (non-billable) Z77.0 Contact with and (suspected) exposure to hazardous, chiefly nonmedicinal, chemicals (non-billable) Z77.01 Contact with and (suspected) exposure to hazardous metals (non-billable) Z77.010 Contact with and (suspected) exposure to arsenic Z77.011 Contact with and (suspected) exposure to lead Z77.012 Contact with and (suspected) exposure to uranium Z77.018 Contact with and (suspected) exposure to other hazardous metals Z77.02 Contact with and (suspected) exposure to hazardous aromatic compounds (non-billable) Z77.020 Contact with and (suspected) exposure to aromatic amines Z77.021 Contact with and (suspected) exposure to benzene Z77.028 Contact with and (suspected) exposure to other hazardous aromatic compounds Z77.09 Contact with and (suspected) exposure to other hazardous, chiefly nonmedicinal, chemicals (non-billable) Z77.090 Contact with and (suspected) exposure to asbestos Z77.098 Contact with and (suspected) exposure to other hazardous, chiefly nonmedicinal, chemicals Z77.1 Contact with and (suspected) exposure to environmental pollution and hazards in the physical environment (non-billable) Z77.11 Contact with and (suspected) exposure to environmental pollution (non-billable) Z77.110 Contact with and (suspected) exposure to air pollution Z77.111 Contact with and (suspected) exposure to water pollution Z77.112 Contact with and (suspected) exposure to soil pollution Z77.118 Contact with and (suspected) exposure to other environmental pollution

ICD-10 Z91.A58, Billing FAQ

Is ICD-10 code Z91.A58 billable? +

Yes, Z91.A58 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

Does Z91.A58 affect Medicare Advantage HCC risk adjustment? +

Yes. Z91.A58 maps to CMS-HCC v28 category 134. Capture this diagnosis annually for accurate Medicare Advantage risk score.

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Reviewed by the PayerReady Medical Coding Team

Verified against the CMS 2026 code set on June 1, 2026.

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