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ICD-10 Guide
ICD-10 CodesZ59.811

Z59.811

Housing instability, housed, with risk of homelessness

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

Code Description

ICD-10 Z59.811 is a billable code used to indicate a diagnosis of housing instability, housed, with risk of homelessness.

Key Diagnostic Point:

Z59.811 identifies individuals who are currently housed but face housing instability, which places them at risk of homelessness. This condition is influenced by various social determinants of health, including economic factors, access to healthcare, and community resources. Patients experiencing housing instability may have increased health risks, such as mental health issues, chronic diseases, and substance use disorders. Preventive care and screening are crucial for these individuals, as they often encounter barriers to accessing healthcare services. Regular screenings for mental health, substance use, and chronic conditions can help mitigate health risks. Aftercare services, including case management and social support, are essential to address the underlying issues contributing to housing instability and to prevent homelessness. Proper documentation of housing status and related health concerns is vital for effective care coordination and resource allocation.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Need for comprehensive documentation of social determinants of health.
  • Variability in patient circumstances and risk factors.
  • Potential overlap with other Z codes related to housing and social issues.
  • Requirement for interdisciplinary collaboration in care planning.

Audit Risk Factors

  • Inadequate documentation of housing status and risk factors.
  • Failure to link Z code with appropriate preventive or screening services.
  • Misuse of Z code when a more specific diagnosis is applicable.
  • Lack of interdisciplinary notes that support the need for social services.

Specialty Focus

Medical Specialties

Primary Care

Documentation Requirements

Document housing status, risk factors, and any referrals to social services.

Common Clinical Scenarios

Routine checkups where housing instability is discussed, screenings for mental health or substance use.

Billing Considerations

Consider the impact of housing on overall health and the need for preventive measures.

Public Health

Documentation Requirements

Collect data on housing instability for population health assessments and surveillance.

Common Clinical Scenarios

Community health assessments, outreach programs targeting at-risk populations.

Billing Considerations

Focus on tracking health outcomes related to housing instability and advocating for policy changes.

Coding Guidelines

Inclusion Criteria

Use Z59.811 When
  • Z codes should be used when a patient's condition is influenced by social determinants of health
  • They can be sequenced as primary or secondary diagnoses, depending on the context
  • Payer requirements may vary, so it's essential to verify coverage for services related to social determinants

Exclusion Criteria

Do NOT use Z59.811 When
No specific exclusions found.

Related CPT Codes

99401CPT Code

Preventive medicine counseling and risk factor reduction intervention

Clinical Scenario

Used during visits where housing instability is discussed as a risk factor.

Documentation Requirements

Document the counseling provided and any referrals made.

Specialty Considerations

Primary care providers should focus on the social determinants impacting health.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of social determinants like housing instability, improving the ability to track and address these issues in healthcare settings.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of social determinants like housing instability, improving the ability to track and address these issues in healthcare settings.

Reimbursement & Billing Impact

impact on health, and any preventive or screening services provided.

Resources

Clinical References

  • •
    CDC Social Determinants of Health

Coding & Billing References

  • •
    CDC Social Determinants of Health

Frequently Asked Questions

When should Z59.811 be used?

Z59.811 should be used when a patient is currently housed but at risk of homelessness, and this status impacts their health and access to care. Proper documentation of the housing situation and its effects on health is essential.