2025 ICD-10-CM code Z58.89
Other problems related to physical environment
Medical necessity for services related to Z58.89 is established by demonstrating that the documented environmental problems are directly impacting or posing a risk to the patient's health. This may include exacerbating existing conditions, increasing the risk of developing new conditions, or hindering recovery.
Clinicians use this code to document factors in a patient's social and economic environment that impact health. They should ensure appropriate supporting documentation is present which describes circumstances, problems or potential health hazards due to physical environment.
- Chapter 21: Factors influencing health status and contact with health services (Z00-Z99)
- Persons with potential health hazards related to socioeconomic and psychosocial circumstances (Z55-Z65)
In simple words: This code is used to document problems related to a person's physical environment, such as housing, sanitation, or access to resources, that may negatively impact their health status.It's not used for problems caused by exposure to environmental hazards or toxins, but more for social and economic factors impacting health.
Other problems related to physical environment
Example 1: A patient experiencing homelessness regularly visits a free clinic for basic medical care and to address health issues related to lack of shelter and proper hygiene. The Z58.89 code is used to document the impact of the unstable housing situation on the patient's health., A patient lives in a neighborhood with limited access to healthy food options. This lack of access contributes to their poor diet and obesity. Z58.89 is used to note the problem of food insecurity, while another code describes obesity., An elderly patient lives in substandard housing with inadequate heating and sanitation, both of which impact their health.Z58.89 is used to document these problematic physical environment factors.
Documentation should clearly describe the specific environmental problems encountered by the patient. Details about housing conditions, access to resources, socioeconomic status, and how these factors impact the patient's current health status or pose potential health risks should be included.
** This code is a billable ICD-10-CM code used to indicate a diagnosis for reimbursement purposes. The code was added on April 1, 2023. It falls under the category 'Persons with potential health hazards related to socioeconomic and psychosocial circumstances (Z55-Z65)'.