Medical noncompliance

From CCMDB Wiki
ICD10 Diagnosis
Dx: Medical noncompliance
ICD10 code: Z91.1
Pre-ICD10 counterpart: none assigned
Charlson/ALERT Scale: none
APACHE Como Component: none
APACHE Acute Component: none
Start Date:
Stop Date:
External ICD10 Documentation

This diagnosis is a part of ICD10 collection.

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    • 2019-01-01
    • 2999-12-31
    • Z91.1
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Additional Info

  • This code refers to a consistent PATTERN OVER TIME whereby a patient has not -- prior to admission -- followed doctors' orders for medical management in a way that may harm them.
    • Thus, it can be used as a comorbid diagnosis or an admit diagnosis, but should NOT be used as an acquired diagnosis.
  • This can occur either by willful choice, or the person now understanding the instructions, or even not being able to afford medications, etc.
  • While this USUALLY means not taking their meds, it can also refer to not doing other things recommended in a way that may harm them (e.g. an MI patient who isn't going to cardiac rehab).
  • In chronic hemodialysis population-those not showing up for or missing multiple treatments.
  • Those with chronic serious infections not showing up for their IV antibiotics in community
  • Do not however, use this code simply to identify a patient who is medically incompetent to make their own decisions.
    • We are not seeking to specifically code or track people who are unable to make their own medical decisions.
    • However, if there is a medical/neurologic/psychiatric reason for the patient to be deemed unable to make their own decisions, then code THAT entity.
    • And if in such a setting the patient is medically noncompliant (as above), code that too.
  • To operationalize this, only code it if the medical management with which they were noncompliant is directly or strongly related to an Admit Diagnosis
    • e.g. where you should code it: Admitted for hypertensive emergency and was not taking prescribed anti-hypertensive medications
    • e.g. where you should NOT code it: Admitted for pneumonia, with hypertension as a Comorbid Diagnosis was not taking prescribed anti-hypertensive medications
  • Based on the above, this code should only be used as an Admit Diagnosis, i.e. noncompliance with some aspect of their care is related to a medical reason for admission. So don't code it as a Comorbid Diagnosis.


Como Admit Acquired Primary Limits

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Alternate ICD10s to consider coding instead or in addition

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