Medical noncompliance: Difference between revisions

From CCMDB Wiki
Jump to navigation Jump to search
Line 24: Line 24:
**e.g. where you should code it:  Admitted for hypertensive emergency and was not taking prescribed anti-hypertensive medications
**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
**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]].
{{DA| 1
* For further coding clarification, can this code be used as an admit diagnosis and/or a comorb diagnosis? Is this code a candidate for Combined ICD10 codes? Thanks! (Pam) }}


== Alternate ICD10s to consider coding instead or in addition ==
== Alternate ICD10s to consider coding instead or in addition ==

Revision as of 10:27, 2021 August 5

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.

  • SMW
    • 2019-01-01
    • 2999-12-31
    • Z91.1
  • Cargo


  • Categories
  • SMW
  • Cargo


  • Categories

Additional Info

  • This code refers to a pattern whereby a patient has not -- prior to admission -- followed doctors' orders for medical management in a way that may harm them.
  • 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.

Alternate ICD10s to consider coding instead or in addition

Candidate Combined ICD10 codes

Related CCI Codes

Data Integrity Checks (automatic list)

none found

Related Articles

Related articles:


Show all ICD10 Subcategories

ICD10 Categories: ANCA-associated Vasculitis (AAV), Abdominal trauma, Abortion, Acute intoxication, Addiction, Adrenal Insufficiency, Adverse effect, Alcohol related, Allergy, Anemia, Anesthetic related, Aneurysm, Antibiotic resistance, Antidepressant related, Aortic Aneurysm, Arrhythmia, Arterial thromboembolism, Asthma, Atherosclerosis, Awaiting/delayed transfer, Bacteria, Benign neoplasm, Breast disease, Burn, COVID, Cannabis related, Cardiac septum problem, Cardiovascular, Cerebral Hemorrhage/Stroke, Chemical burn, Chronic kidney disease, Cirrhosis, Cocaine related, Decubitus ulcer, Delirium, Dementia, Diabetes, Diagnosis implying death, Double duty pathogen, ENT, Encephalitis, Encephalopathy, Endocrine disorder, Endocrine neoplasm, Exposure, Eye, Female genital neoplasm, Fistula, Fracture, Fungus, GI ulcer, Gastroenteritis, Gastrointestinal, Gastrointestinal neoplasm, Hallucinogen related, Has one, Head trauma, Head trauma (old), Healthcare contact, Heart valve disease, Heme/immunology, Heme/immunology neoplasm, Hemophilia, Hemorrhage, Hepatitis, Hereditary/congenital, Hernia, Hypertension, Hypotension, Iatrogenic, Iatrogenic infection, Iatrogenic mechanism, Imaging, Infection requiring pathogen, Infection with implied pathogen, Infectious disease, Inflammatory Bowel Disease, Influenza, Inhalation, Intra-abdominal infection, Ischemia, Ischemic gut, Ischemic heart disease, Joint/ligament trauma, Leukemia, Liver disease, Liver failure, Lower limb trauma, Lower respiratory tract infection, Lymphoma, Male genital neoplasm, Mechanism, Meningitis, Metabolic/nutrition, Metastasis, Misc, Muscle problem, Muscles/tendon trauma, Musculoskeletal/soft tissue, Musculoskeletal/soft tissue neoplasm... further results