Z91.190 ICD-10-CM Code: Patient's noncompliance with other medical treatment and regimen due to financial hardship

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for Z91.190 in the official ICD-10-CM tabular list, quoted as published.

Source: CMS/CDC — ICD-10-CM Tabular ListRelease: FY2026Effective: October 1, 2025

Notes without a marker are published on Z91.190 itself; “inherited from” names the category or block whose note applies here.

Coder workflow for Z91.190

MedCoder structured workflow — derived from this code’s own official record

Before you code Z91.190

1. Z91.190’s title joins a condition with an associated condition or complication. Confirm each component is documented. Where the classification presumes the link through the “with” convention, only a provider statement that the conditions are unrelated defeats it. A combination code is assigned only when it fully identifies the documented conditions; a required second code for the stage, type or manifestation is still reported when the notes ask for it (Guidelines I.B.9, I.A.15).

   Guide: Combination codes →

2. Confirm the reason for the encounter this Z code records: a status — a condition, carrier state or sequela that may affect care, distinct from a current complication of it. Check whether the code may be reported as first-listed or principal — some Z codes are limited to one position — and do not report a history or status code for a condition documented as current. Z code categories and their reporting positions (Guidelines I.C.21.c.3, I.C.21.c.15).

   Guide: Status codes (Z codes) →

Documentation check

The provider’s diagnostic statement

Codes are assigned from the provider’s documented diagnosis, not from clinical criteria, test values or a medication list (Guidelines I.A.19).

The associated condition or complication

Whether the associated condition the title names is documented; the “with” convention presumes some links, and a provider statement that the conditions are unrelated defeats it (Guidelines I.A.15).

The reason for the encounter

Whether the code records the encounter’s purpose, a status, or a history — and whether it may be first-listed (Guidelines I.C.21.c).

Official instructions as workflow

• Excludes2 — not part of Z91.190(6 notes)

  Coding workflow: The conditions named in this note are not included in Z91.190. When the record documents both, both may be reported; the note is a boundary, not a prohibition.

  CompareZ91.A, Z77, Z77.1, N90.81, Z57, Z87.81

  See the official tabular notes · Guidelines I.A.12.b

• Code Also — related condition(2 notes)

  Coding workflow: Review the related condition when both are documented and the instruction applies. A Code Also note does not fix sequencing; the order follows the circumstances of the encounter.

  See the official tabular notes · Guidelines I.A.17

Coding decision scenarios

Pattern scenarios for this code’s structure — decision rules, not clinical cases

Every row is derived from this code’s own record — its title, tabular notes, 7th-character family and same-category siblings — with fixed MedCoder wording; nothing is inferred about a patient. The official notes and guideline text are in the sections each row links to, and they control.

Indexed Clinical Terms (2)

Official source data — entries quoted as published, in the Index’s own lookup phrasing

Clinical term phrases from the official ICD-10-CM Index to Diseases and Injuries that map to this code. These are alphabetic-index entries shown as the Index writes them — lookup phrasing, not necessarily the wording of a final diagnosis.

• Nonadherence to medical treatment, specified NEC, due to, financial hardship
• Noncompliance, with, medical treatment, specified NEC, due to, financial hardship

Official Coding Guidelines

Official source data — quoted verbatim from the CMS/NCHS Official Guidelines

Official source data — quoted verbatim from the CMS/NCHS Official Guidelines

Verbatim excerpts from the ICD-10-CM Official Guidelines for Coding and Reporting (CMS/NCHS) that govern this code.

Don’t confuse Z91.190 with…

MedCoder analysis — pairs from this code’s official notes, distinctions written by MedCoder

The codes most likely to be picked instead of Z91.190 — named in its own official notes, or sharing its laterality or encounter family — with what separates them and which documentation moves the case. Each links to the full comparison.

• Z91.199— Specificity relationship (Review)

  Overlapping diagnoses in the same category.

  Overlapping codes in the same category — the documentation decides which is the more specific fit.

  What moves you there: A record that documents no more than “Patient's noncompliance with other medical treatment and regimen due to unspecified reason” takes Z91.199; specificity in the record moves it back here.

  Full comparison: Z91.190 vs Z91.199 →

• Z91.A— Excludes2 relationship (Informational)

  Distinct conditions — both may be reported.

  A distinct condition — both may be reported when both are documented.

  What moves you there: Documentation of caregiver noncompliance with patient's medical treatment and regimen adds Z91.A; it is not part of this code and both may be reported when both are documented.

  Full comparison: Z91.190 vs Z91.A →

• Z77— Excludes2 relationship (Informational)

  Distinct conditions — both may be reported.

  A distinct condition — both may be reported when both are documented.

  What moves you there: Documentation of contact with and (suspected) exposures hazardous to health adds Z77; it is not part of this code and both may be reported when both are documented.

  Full comparison: Z91.190 vs Z77 →

• Z77.1— Excludes2 relationship (Informational)

  Distinct conditions — both may be reported.

  A distinct condition — both may be reported when both are documented.

  What moves you there: Documentation of exposure to pollution and other problems related to physical environment adds Z77.1; it is not part of this code and both may be reported when both are documented.

  Full comparison: Z91.190 vs Z77.1 →

• N90.81— Excludes2 relationship (Informational)

  Distinct conditions — both may be reported.

  A distinct condition — both may be reported when both are documented.

  What moves you there: Documentation of female genital mutilation status adds N90.81; it is not part of this code and both may be reported when both are documented.

  Full comparison: Z91.190 vs N90.81 →

• Z57— Excludes2 relationship (Informational)

  Distinct conditions — both may be reported.

  A distinct condition — both may be reported when both are documented.

  What moves you there: Documentation of occupational exposure to risk factors adds Z57; it is not part of this code and both may be reported when both are documented.

  Full comparison: Z91.190 vs Z57 →

Relationships are read from this code's own official notes, its laterality siblings and its encounter family; the wording of each distinction is MedCoder editorial, and the documentation named in each “what moves you there” line is the official note phrase or sibling title itself. Source: CMS ICD-10-CM tabular instructional notes; ICD-10-CM Official Guidelines, Section I.A.12.a.

Verify Before Coding

• Principal-diagnosis restriction. The Medicare Code Editor lists this code as unacceptable as a principal diagnosis: it describes a circumstance influencing health status rather than a current illness or injury being treated. It is valid as a secondary diagnosis.

From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim in Claim Check.

Relationships & Classification

MedCoder structured relationships — computed from published CMS and AHRQ datasets

MS-DRG Grouper Relationships (FY2026)

Potential MS-DRG participation — not a DRG assignment.

FY2026 MS-DRG: not on the CMS CC/MCC list — as a secondary diagnosis this code does not change MS-DRG severity for that release.

Named in the grouper logic of 1 MS-DRG: DRG 951 (MDC 23).

From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.

Clinical classification (AHRQ CCSR):FAC025 — Other specified status (default).

Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.

Related Codes

Principal diagnosis restriction (Medicare Code Editor)

Not acceptable as a principal diagnosis on an inpatient claim.

Same clinical category (CCSR)

AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical category (Other specified status).

Z91.128 — Patient's intentional underdosing of medication regimen for other reason, Z91.130 — Patient's unintentional underdosing of medication regimen due to age-related debility, Z91.138 — Patient's unintentional underdosing of medication regimen for other reason, Z91.14 — Patient's other noncompliance with medication regimen, Z91.141 — Patient's other noncompliance with medication regimen due to financial hardship, Z91.148 — Patient's other noncompliance with medication regimen for other reason, Z91.15 — Patient's noncompliance with renal dialysis, Z91.151 — Patient's noncompliance with renal dialysis due to financial hardship, Z91.158 — Patient's noncompliance with renal dialysis for other reason, Z91.19 — Patient's noncompliance with other medical treatment and regimen, Z91.198 — Patient's noncompliance with other medical treatment and regimen for other reason, Z91.199 — Patient's noncompliance with other medical treatment and regimen due to unspecified reason, Z91.83 — Wandering in diseases classified elsewhere, Z91.841 — Risk for dental caries, low, Z91.842 — Risk for dental caries, moderate, Z91.843 — Risk for dental caries, high, Z91.849 — Unspecified risk for dental caries, Z91.85 — Personal history of military service, Z91.89 — Other specified personal risk factors, not elsewhere classified, Z91.A10 — Caregiver's noncompliance with patient's dietary regimen due to financial hardship, +232 more

Contextual Map

Every relationship of Z91.190 in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.

Hierarchy

• Z00-Z99 — Chapter 21: Factors Influencing Health Status and Contact with Health Services (Z00-Z99) (Z00-Z99)[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• Z77-Z99 — Persons with potential health hazards related to family and personal history and certain conditions influencing health status[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2026

Clinical classification (CCSR)

• FAC025 — Other specified status[CCSR]— AHRQ CCSR for ICD-10-CM Diagnoses (HCUP)

MS-DRG Grouper

• DRG 951 — OTHER FACTORS INFLUENCING HEALTH STATUS[MS-DRG]: “OTHER FACTORS INFLUENCING HEALTH STATUS (MDC 23)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2026

MDC crossing

• MDC 23 — Factors Influencing Health Status and Other Contacts with Health Services[MDC crossing]: “Factors Influencing Health Status and Other Contacts with Health Services — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs. 1,235 same-MDC procedures group here; browse them on the MDC page.”— CMS MS-DRG Definitions Manual · FY2026

Index entries

• Nonadherence to medical treatment, specified NEC, due to, financial hardship[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
• Noncompliance, with, medical treatment, specified NEC, due to, financial hardship[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026

Nearest codes (40)

• Z91 — Personal risk factors, not elsewhere classified[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• Z91.048 — Other nonmedicinal substance allergy status[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• Z91.09 — Other allergy status, other than to drugs and biological substances[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• Z91.1 — Patient's noncompliance with medical treatment and regimen[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• Z91.11 — Patient's noncompliance with dietary regimen[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• Z91.110 — Patient's noncompliance with dietary regimen due to financial hardship[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• Z91.118 — Patient's noncompliance with dietary regimen for other reason[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• Z91.119 — Patient's noncompliance with dietary regimen due to unspecified reason[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• and 32 more

Change history

• FY2023 — Added to the code set[Change history]— CMS release files (code change ledger) · icd10cm-fy2023

Sources for this page

Codes, titles, notes, index terms and mappings on this page are transcribed from the datasets below. Relationships MedCoder computed and text MedCoder wrote are labelled where they appear.

Code, title, tabular notes and index terms Official source data

CMS/CDC ICD-10-CM FY2026 tabular list, index and tables, effective October 1, 2025 Release, file and checksum · Publisher’s page

Coding guidelines Official source data

ICD-10-CM Official Guidelines for Coding and Reporting (FY2026), quoted by section Release, file and checksum · Publisher’s page

Claim edits Official source data

CMS Definitions of Medicare Code Edits — v43.1 (April 2026) Release, file and checksum · Publisher’s page

Inpatient payment groups Official source data

CMS MS-DRG Definitions Manual (incl. Appendix B diagnosis index, Appendix C CC/MCC list, Appendix E procedure index) and IPPS Final Rule tables — v43 Release, file and checksum · Publisher’s page

Change history and date-of-service validity Official source data

CMS ICD-10-CM release addenda, ingested release by release into the change ledger Release, file and checksum · Publisher’s page

Comparisons, relationships and the contextual map MedCoder structured relationship

Computed by MedCoder from the tabular notes and tables above; every derived relationship is marked as derived where it appears

Summary and FAQ answers MedCoder explanation

Written by MedCoder to explain the sources above: drafted with AI assistance, checked by a person against the release files, and labelled as MedCoder text where it appears. Not official text.

Labels on this page: Official source data · MedCoder structured relationship · MedCoder explanation. How to read the labels · All data sources and release dates

Nearest Codes in This Family

Official ICD-10-CM classifications closest to Z91.190 in its code family, with their registry titles.

• Z91.148 — Patient's other noncompliance with medication regimen for other reason
• Z91.15 — Patient's noncompliance with renal dialysis
• Z91.151 — Patient's noncompliance with renal dialysis due to financial hardship
• Z91.158 — Patient's noncompliance with renal dialysis for other reason
• Z91.19 — Patient's noncompliance with other medical treatment and regimen
• Z91.198 — Patient's noncompliance with other medical treatment and regimen for other reason
• Z91.199 — Patient's noncompliance with other medical treatment and regimen due to unspecified reason
• Z91.4 — Personal history of psychological trauma, not elsewhere classified
• Z91.41 — Personal history of adult abuse
• Z91.410 — Personal history of adult physical and sexual abuse

View all codes in the Z91 family