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v1.0.0
ICD-10 Guide
ICD-10 CodesZ58

Z58

Problems related to physical environment

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/12/2025

Code Description

ICD-10 Z58 is a billable code used to indicate a diagnosis of problems related to physical environment.

Key Diagnostic Point:

Z58 codes are used to capture issues arising from the physical environment that can impact health status and necessitate contact with health services. These problems may include exposure to hazardous conditions, inadequate housing, or environmental pollutants that can lead to health complications. Understanding the social determinants of health is crucial, as factors such as socioeconomic status, education, and community safety can influence an individual's health outcomes. Preventive care and screening are essential in identifying individuals at risk due to their environment, allowing for timely interventions. Aftercare may involve follow-up assessments to monitor health changes related to environmental factors. Accurate documentation of these conditions is vital for effective coding and reimbursement, as well as for public health tracking and resource allocation.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of environmental factors that can affect health
  • Need for detailed documentation to support the Z code
  • Potential overlap with other Z codes related to social determinants
  • Variability in payer requirements for Z code usage

Audit Risk Factors

  • Insufficient documentation linking environmental issues to health conditions
  • Inconsistent use of Z58 in relation to other Z codes
  • Failure to provide preventive care or screening documentation
  • Inadequate follow-up care records

Specialty Focus

Medical Specialties

Primary Care

Documentation Requirements

Document environmental assessments, patient history related to exposure, and preventive measures taken.

Common Clinical Scenarios

Routine checkups where environmental factors are assessed, screenings for lead exposure in children, and aftercare for patients with respiratory issues linked to air quality.

Billing Considerations

Consideration of social determinants such as housing stability and community resources.

Public Health

Documentation Requirements

Population health data, environmental health assessments, and surveillance reports.

Common Clinical Scenarios

Epidemiological studies on the impact of pollution, community health initiatives addressing environmental hazards.

Billing Considerations

Focus on tracking health outcomes related to environmental exposures at the community level.

Coding Guidelines

Inclusion Criteria

Use Z58 When
  • Z codes should be used when the primary reason for the encounter is related to the physical environment
  • They can be sequenced as secondary diagnoses when they contribute to the patient's health status
  • Payer requirements may vary, so it is essential to check specific guidelines for coverage

Exclusion Criteria

Do NOT use Z58 When
No specific exclusions found.

Related Codes

Child Codes

4 codes
Z58.6
Inadequate drinking-water supply
Z58.8
Other problems related to physical environment
Z58.81
Basic services unavailable in physical environment
Z58.89
Other problems related to physical environment

Related CPT Codes

99385CPT Code

Initial preventive medicine evaluation and management, new patient

Clinical Scenario

Used for preventive visits where environmental factors are assessed.

Documentation Requirements

Document environmental history and risk factors.

Specialty Considerations

Primary care providers should focus on comprehensive assessments.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for greater specificity in coding environmental issues, enabling better tracking of health outcomes related to physical environments.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for greater specificity in coding environmental issues, enabling better tracking of health outcomes related to physical environments.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for greater specificity in coding environmental issues, enabling better tracking of health outcomes related to physical environments.

Resources

Clinical References

  • •
    CDC Environmental Health Guidelines

Coding & Billing References

  • •
    CDC Environmental Health Guidelines

Frequently Asked Questions

When should Z58 be used in coding?

Z58 should be used when a patient's health status is significantly impacted by environmental factors, and it is essential to document the specific environmental issues and their effects on health.