Loading...

    Explore
    • Policy Monitoring
    • Live Policy Feed
    • Billing Codes
    • NPI Medicare & Medicaid
    • Healthcare Providers
    • Health Insurance Payers
    • States
    • Service Lines
    • Taxonomy Codes
    Lookup tools
    • Billing Code Lookup
    • CPT Modifier Lookup
    • Provider Taxonomy Code Lookup
    • Healthcare Provider & Facility Lookup
    • Health Insurance Payer Lookup
    • Payer Contact Directory

    Policy & Benchmark Tools

    • Prior Authorization Lookup
    • Coverage Criteria Lookup
    • Timely Filing Lookup
    • Billing Code Reimbursement Rates
    • Payer Comparison Dashboard
    • Facility Comparison Dashboard
    • All tools

    Company

    • About OpenPayer
    • Data Sources
    • Trek Health
    OpenPayerby Trek Health
    LinkedInYouTube

    © 2026 Trek Health. All rights reserved.

    OpenPayer is built and maintained by Trek Health.

    v1.0.28
    OpenPayerBilling CodesPersons with potential health hazards related to family and personal history and certain conditions influencing health statusICD-10-CM z91-personal-risk-factors
    Ask Trek AI about this page

    ICD-10-CM Code For Personal Risk Factors Not Elsewhere Classified: Group Overview

    The International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) code group Z91 includes diagnoses documenting personal risk factors and behaviors not classified elsewhere, such as history of falls, allergies to medicinal agents, or patient noncompliance with medical treatment. These ICD-10-CM diagnosis codes are used to document patient-level factors that influence clinical decision-making, care planning, and the complexity of management. Accurate coding within the ICD-10-CM Z91 group supports proper claim adjudication and complete clinical documentation.

    Customize your policy alerts

    Sign up for ICD-10-CM Code For Personal Risk Factors Not Elsewhere Classified: Group Overview policy alerts

    Get alerted when relevant policies change without checking for updates manually.

    Monitor payer policy activity

    Receive email alerts as soon as relevant payer policies are published or updated.

    ICD-10-CM Z91: Personal Risk Factors, Not Elsewhere Classified Overview

    This group captures personal history and behavioral factors that may influence health but are not classified elsewhere, such as personal risk factors for falls, allergies to medications, or noncompliance with medical treatment. These codes pertain to patient-level risk characteristics rather than specific organ systems or acute diagnoses. Accurate coding matters for reimbursement because it documents risk factors that affect care complexity and utilization, supporting appropriate claim adjudication.

    Table of contents

    Progress1 / 6

    Explore openpayer tools

    • Billing CodesCPT, HCPCS, DRG & more
    • Reimbursement RatesCommercial vs. Medicare rate reports
    • ProvidersHospitals & facilities
    • PayersPlans & market footprint
    • Taxonomy CodesNUCC specialty codes
    • ModifiersCPT modifiers & usage
    • Prior AuthorizationPA policies by payer & drug
    • Timely FilingFiling deadlines by payer
    • Coverage CriteriaMedical necessity by payer
    • Payer ContactsClaims, PA & appeals contacts
    View all tools

    When to Use

    Use a code from this group when a documented personal risk factor or behavior influences care, treatment decisions, or expected outcomes but is not otherwise classified in another chapter. Select the most specific Z91 code that reflects the patients documented risk factor or behavior to accurately capture clinical complexity.

    ICD-10-CM Codes

    62 rows

    ICD-10-CM CodeDescription
    Z91.010Allergy to peanuts
    Z91.0110Allergy to milk products, unspecified
    Z91.0111Allergy to milk products with tolerance to baked milk
    Z91.0112Allergy to milk products with reactivity to baked milk
    Z91.0120Allergy to eggs, unspecified
    Z91.0121Allergy to eggs with tolerance to baked egg
    Z91.0122Allergy to eggs with reactivity to baked egg
    Z91.013Allergy to seafood
    Z91.014Allergy to mammalian meats
    Z91.018Allergy to other foods
    Z91.02Food additives allergy status
    Z91.030Bee allergy status
    Z91.038Other insect allergy status
    Z91.040Latex allergy status
    Z91.041Radiographic dye allergy status
    Z91.048Other nonmedicinal substance allergy status
    Z91.09Other allergy status, other than to drugs and biological substances
    Z91.110Patient's noncompliance with dietary regimen due to financial hardship
    Z91.118Patient's noncompliance with dietary regimen for other reason
    Z91.119Patient's noncompliance with dietary regimen due to unspecified reason

    Showing 1–20 of 62

    DRG Codes

    1 rows

    DRG CodeDescription
    951Other Factors Influencing Health Status

    Typical Clinical Scenarios

    • An elderly patient presents to the emergency department after a fall at home; they report a history of multiple prior falls and difficulty with balance but no acute fracture on imaging. The visit focuses on fall risk assessment and prevention planning because the patient’s personal history of recurrent falls contributes to their current hazard profile and influences care decisions. Typical codes: Z91.81, Z91.410
    • A middle-aged individual seen in primary care for medication reconciliation reports repeatedly missing doses of prescribed antihypertensive therapy due to forgetfulness and irregular routines, resulting in poorly controlled blood pressure. The clinician documents the patient’s noncompliance with medication to guide treatment adjustments and counseling, assigning a code that captures personal history of noncompliance with medical treatment. Typical codes: Z91.14, Z91.12
    • A young adult is evaluated in the outpatient clinic after sustaining a needlestick injury at work; they have a known allergy to standard post-exposure prophylaxis and have previously refused hepatitis B vaccination. The visit focuses on assessing personal risk factors that alter infection prevention planning and follow-up; a code reflecting personal history of noncompliance or refusal of prophylactic immunization or a code denoting allergy-related refusal is applied. Typical codes: Z91.11, Z91.12

    Related Codes

    Z77-OTHER-CONTACT-WITH-EXPOSURES

    ICD-10-CM Code For Other Contact With And Suspected Exposures Hazardous To Health: Group Overview

    Z78-OTHER-SPECIFIED-HEALTH-STATUS

    ICD-10-CM Code For Other Specified Health Status: Group Overview

    Z79-LONG-TERM-DRUG-THERAPY

    ICD-10-CM Code For Long Term Current Drug Therapy: Group Overview

    Z80-FAMILY-HISTORY-OF-CANCER

    ICD-10-CM Code For Family History Of Primary Malignant Neoplasm: Group Overview

    Z81-FAMILY-HISTORY-OF-MENTAL-DISORDERS

    ICD-10-CM Code For Family History Of Mental And Behavioral Disorders: Group Overview

    Z82-FAMILY-HISTORY-OF-DISABILITIES

    ICD-10-CM Code For Family History Of Certain Disabilities And Chronic Diseases: Group Overview

    Z83-FAMILY-HISTORY-OF-OTHER-SPECIFIC-DISORDERS

    ICD-10-CM Code For Family History Of Other Specific Disorders: Group Overview

    Z84-FAMILY-HISTORY-OTHER-CONDITIONS

    ICD-10-CM Code For Family History Of Other Conditions: Group Overview

    Z85-PERSONAL-HISTORY-OF-MALIGNANT-NEOPLASM

    ICD-10-CM Code For Personal History Of Malignant Neoplasm: Group Overview

    Z86-PERSONAL-HISTORY-OF-CERTAIN-DISEASES

    ICD-10-CM Code For Personal History Of Certain Other Diseases: Group Overview

    Showing 1–10 of 22

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
    Published by

    Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.