ICD-10 Z91.A58
Billable / Specific HCC v28: 134Caregiver's noncompliance with patient's renal dialysis for other reason
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.
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
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.
Showing top 10 of 33 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing Z91.A58.
4 Medicare
CPT Codes Commonly Billed with Z91.A58
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.A58
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.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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