Is ICD-10-CM code Z81 billable?

No, Z81 (Family history of mental and behavioral disorders) 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 Z81 belong to?

Z81 belongs to Chapter 21 of the ICD-10-CM tabular list: Z00–Z99 (Factors Influencing Health Status and Contact with Health Services).

Z81Not billable, use a more specific code below

Family history of mental and behavioral disorders

In Persons with potential health hazards related to family and personal history and certain conditions influencing health status (Z77-Z99), chapter 21: Factors Influencing Health Status and Contact with Health Services

6 billable codes under Z81: none are a CC or MCC; none map to an HCC.

Instructional notes

Also applies, from Persons with potential health hazards related to family and personal history and certain conditions influencing health status (Z77-Z99)

These notes sit on Z77-Z99 and apply to every code under it, including Z81.

Code also: add a code for this too, order depends on the encounter

any follow-up examination (Z08-Z09)

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 Z81

Z81 can't be used on a claim. Pick a billable code below; grey headings group them.

Z81 MS-DRGs

As the principal diagnosis, the billable codes under Z81 group to MS-DRG 951 or 795 (v44.0). Which one applies depends on procedures performed, secondary diagnoses (CC/MCC), and the patient's age and discharge status.

DRG 951 Other Factors Influencing Health Status (6 of 6 codes)
DRG 795 Normal Newborn (1 of 6 codes)

About the condition

Plain-language background from MedlinePlus (National Library of Medicine), not coding guidance.

Family History

Your family history includes health information about you and your close relatives. Families have many factors in common, including their genes, environment, and lifestyle. Looking at these factors can help you figure out whether you have a higher risk for certain health problems, such as heart disease, stroke, and cancer.

Mental Disorders

Mental disorders (or mental illnesses) are conditions that affect your thinking, feeling, mood, and behavior. They may happen over a short period of time or come and go. Some can be chronic (long-lasting). They can affect your ability to relate to others and function each day..

Code history

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