Is Z59.7 a mental health diagnosis?

Yes, code Z59.7 is identified as a mental health diagnosis.

Is Z59.7 an acceptable principal diagnosis?

No, code Z59.7 is identified as an unacceptable principal diagnosis (Edit 113) due to OPPS coding requirements.

Z59.7 Non-Billable Code

Insufficient social insurance and welfare support

Effective From: 10/01/2016

Effective To: 09/30/2024

Chapter Classification

Chapter 21 Factors influencing health status and contact with health services (Z00-Z99)

Section Detail

Z55-Z65 Persons with potential health hazards related to socioeconomic and psychosocial circumstances (Z55-Z65)

Code Hierarchy

This code is a child of Z59.

As a non-billable code, it requires more specific digits to be used on a medical claim.

More Specific Diagnosis Codes

This code is not billable as it requires a higher level of specificity. Select a more specific code below.

Z59.71 - Insufficient health insurance coverage Billable
Z59.72 - Insufficient welfare support Billable

OPPS Editing Flags

External Cause No

Mental Health Yes

Manifestation (Edit 89) No

Code First Applicable ?This code represents a manifestation of an underlying disease. The underlying condition must be coded first as the principal diagnosis. No

Unacceptable PDX (Edit 113) Yes

PDX Exclusion Logic

OPPS Required: Yes
Bill Type Override: No

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