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v1.0.0
ICD-10 Guide
ICD-10 CodesZ60.5

Z60.5

Target of (perceived) adverse discrimination and persecution

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

Code Description

ICD-10 Z60.5 is a billable code used to indicate a diagnosis of target of (perceived) adverse discrimination and persecution.

Key Diagnostic Point:

Z60.5 is used to indicate that an individual perceives themselves as a target of adverse discrimination or persecution, which can significantly impact their mental and physical health. This code is relevant in contexts where social determinants of health, such as socioeconomic status, race, ethnicity, and sexual orientation, contribute to health disparities. Individuals facing discrimination may experience increased stress, anxiety, and depression, leading to a higher utilization of health services for mental health support. Preventive care and screening for mental health issues are crucial in these cases, as early intervention can mitigate long-term health consequences. Additionally, aftercare services may be necessary to support individuals in coping with the effects of discrimination, emphasizing the importance of a holistic approach to health care that addresses both physical and mental health needs.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Subjectivity of perceived discrimination can complicate documentation.
  • Need for comprehensive patient history to establish context.
  • Potential overlap with mental health diagnoses requiring careful differentiation.
  • Variability in how different healthcare providers interpret and document discrimination experiences.

Audit Risk Factors

  • Inadequate documentation of the patient's experiences of discrimination.
  • Failure to link Z60.5 with appropriate mental health diagnoses.
  • Lack of evidence for the impact of discrimination on health outcomes.
  • Improper sequencing of Z codes with primary diagnoses.

Specialty Focus

Medical Specialties

Primary Care

Documentation Requirements

Document patient history, perceived discrimination experiences, and any mental health referrals.

Common Clinical Scenarios

Routine checkups where patients disclose experiences of discrimination, screenings for anxiety or depression.

Billing Considerations

Consider social determinants affecting health, such as access to care and community resources.

Public Health

Documentation Requirements

Collect data on population-level discrimination experiences and their health impacts.

Common Clinical Scenarios

Epidemiological studies assessing health disparities related to discrimination.

Billing Considerations

Focus on tracking health outcomes and developing interventions to address discrimination-related health issues.

Coding Guidelines

Inclusion Criteria

Use Z60.5 When
  • Z codes are used when a patient presents with a condition that is not a disease but affects health status
  • 5 should be sequenced appropriately, often as a secondary diagnosis to capture the impact of discrimination on health
  • Payer requirements may vary, so it is essential to check specific guidelines for coverage

Exclusion Criteria

Do NOT use Z60.5 When
No specific exclusions found.

Related CPT Codes

96127CPT Code

Brief emotional/behavioral assessment

Clinical Scenario

Used during visits where patients disclose experiences of discrimination.

Documentation Requirements

Document the assessment results and any referrals made.

Specialty Considerations

Primary care providers should be aware of the social context affecting patient health.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for greater specificity in coding social determinants of health, including experiences of discrimination, which can lead to improved understanding and management of health disparities.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for greater specificity in coding social determinants of health, including experiences of discrimination, which can lead to improved understanding and management of health disparities.

Reimbursement & Billing Impact

impact on health, and any preventive or aftercare services provided. Ensure that all relevant codes are included to support the medical necessity of services rendered.

Resources

Clinical References

  • •
    CDC Social Determinants of Health

Coding & Billing References

  • •
    CDC Social Determinants of Health

Frequently Asked Questions

How should Z60.5 be documented in a patient's record?

Document the patient's experiences of discrimination, the impact on their health, and any referrals or interventions provided. Include specific details that illustrate how discrimination affects their health status.