2025 ICD-10-CM code Z58.81

Basic services, such as internet, telephone, or utilities, are unavailable due to the physical environment.

This code should be used only when the lack of access to basic services directly and significantly impacts the patient's health.It should not be used as the primary diagnosis but rather as a secondary code to explain the impact of the social determinant of health.

Medical necessity is established by demonstrating how the lack of basic services directly impacts the patient's health, making it difficult or impossible for them to manage their condition or access essential healthcare services. This might involve documentation of treatment delays, exacerbations of symptoms, or missed appointments due to the lack of access.

The clinical responsibility involves documenting the lack of access to basic services and its impact on the patient's health.This might include assessing the patient's needs, developing a care plan to mitigate the effects of the environmental limitations, and coordinating with community resources to address the underlying issues.

IMPORTANT May be used in conjunction with other codes to describe the specific service unavailable and the resulting impact on the patient's health.Consider additional codes from Z55-Z65 to capture other socioeconomic and psychosocial factors impacting the patient.

In simple words: This code means the patient doesn't have access to basic things like internet, phone, or utilities because of where they live or the condition of their home. This can make it hard to get healthcare, go to school or work, and connect with others, impacting their health.

This code signifies that a patient's health is impacted by a lack of access to essential services (internet, telephone, utilities) resulting from issues within their physical environment.This could be due to geographic location, infrastructure limitations, or other environmental factors.The unavailability of these services can significantly affect a person's ability to access healthcare, education, employment, and social support, ultimately impacting their overall health and well-being.

Example 1: A patient living in a rural area without internet access is unable to participate in telehealth appointments or access online health information, delaying diagnosis and treatment., A patient living in a building with unreliable electricity frequently experiences interruptions in the use of medical equipment, impacting their health management., A patient lacks access to a reliable phone line, hindering their ability to schedule appointments, communicate with healthcare providers, and access emergency services.

Documentation should include a detailed description of the unavailable services, the reason for unavailability, and the impact of this lack of access on the patient’s health and well-being. Supporting documentation may include provider notes, social worker assessments, and evidence of attempts to secure these services.

** This code is particularly relevant for patients in underserved or rural communities, those experiencing homelessness, and individuals with limited financial resources.It is crucial to consider and document the interplay of this code with other social determinants of health, which could include inadequate housing, food insecurity, and lack of transportation.

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