Is ICD-10-CM code Z64 billable?

No, Z64 (Problems related to certain psychosocial circumstances) is a non-billable ICD-10-CM code. It must be coded to a more specific subcategory before it can be used for reimbursement.

What chapter does ICD-10-CM code Z64 belong to?

Z64 belongs to Chapter 21 of the ICD-10-CM tabular list: Z00–Z99 (Factors Influencing Health Status and Contact with Health Services).

Z64Not billable, use a more specific code below

Problems related to certain psychosocial circumstances

In Persons with potential health hazards related to socioeconomic and psychosocial circumstances (Z55-Z65), chapter 21: Factors Influencing Health Status and Contact with Health Services

3 billable codes under Z64: none are a CC or MCC; none map to an HCC.

Official coding guidelines

From the ICD-10-CM Official Guidelines for Coding and Reporting, FY 2027 (CMS and NCHS). Links open the PDF at the right page.

Covers when and how to use Z codes (Z00-Z99) for encounters and supplementary information, including contact, status, history, screening, aftercare, exams, and social determinants of health.

Use of Z Codes in Any Healthcare Setting (page 92)
Z Codes Indicate a Reason for an Encounter or Provide Additional Information about a Patient Encounter (page 93)
Categories of Z Codes (page 93)

Read Section I.C.21 (page 92)

All codes under Z64

Z64 can't be used on a claim. Pick a billable code below; grey headings group them.

Z64 MS-DRGs

As the principal diagnosis, the billable codes under Z64 group to these 7 MS-DRGs (v44.0). Which one applies depends on procedures performed, secondary diagnoses (CC/MCC), and the patient's age and discharge status.

DRG 742 Uterine and Adnexa Procedures for Non-Malignancy with CC/MCC (1 of 3 codes)
DRG 743 Uterine and Adnexa Procedures for Non-Malignancy without CC/MCC (1 of 3 codes)
DRG 760 Menstrual and Other Female Reproductive System Disorders with CC/MCC (1 of 3 codes)
DRG 761 Menstrual and Other Female Reproductive System Disorders without CC/MCC (1 of 3 codes)
DRG 770 Abortion with D&C, Aspiration Curettage or Hysterotomy (1 of 3 codes)
DRG 779 Abortion without D&C (1 of 3 codes)
DRG 951 Other Factors Influencing Health Status (1 of 3 codes)

Code history

Valid since FY2016, when ICD-10-CM took effect on October 1, 2015. No changes since.