2025 ICD-10-CM code Z75.5
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Factors influencing health status and contact with health services - Persons encountering health services in other circumstances Chapter 21: Factors influencing health status and contact with health services Feed
Holiday relief care; provision of healthcare facilities to a person usually cared for at home, allowing family members a vacation.
Medical necessity for Z75.5 is established by documenting the need for temporary alternative care to allow the primary caregiver a break.The patient's condition should be stable, and the respite care should be planned and temporary.
The clinical responsibility depends on the type of care provided during the respite period. It could involve physicians, nurses, or other healthcare professionals depending on the patient’s needs. Documentation of the services provided is crucial for proper billing.
- Chapter 21: Factors influencing health status and contact with health services
- Z75 Problems related to medical facilities and other health care
In simple words: This code means that someone who is usually cared for at home is getting temporary care somewhere else so that their family can take a vacation or get a break.
Z75.5, Holiday relief care, in the ICD-10-CM classification system, denotes the provision of healthcare services or facilities to an individual typically cared for at home, primarily to enable family caregivers to take a break or vacation.This includes respite care, offering temporary relief to primary caregivers. The code is utilized when the reason for the encounter is the need for temporary alternative care arrangements, not a specific disease or injury.
Example 1: A 70-year-old patient with Alzheimer's disease is admitted to a respite care facility for a week to allow their primary caregiver to go on vacation. Z75.5 is used to indicate the reason for admission, along with codes for any specific services provided during their stay., A family with an adult child with cerebral palsy utilizes a temporary in-home healthcare provider for 5 days so they can attend a family wedding. Z75.5 would be appropriate, along with codes for any services provided during this period., An elderly patient with congestive heart failure requires temporary placement in a skilled nursing facility to give their primary caregiver time to recover from an illness. Z75.5 is used with accompanying codes for any services given at the facility.
The medical record must clearly document the need for temporary care to allow the caregiver respite and not due to the patient’s worsening condition.Documentation should include details about the patient's usual care setting, the duration of respite care, the services provided during the respite period, and the reason for the caregiver needing a break.
** This code is not intended for use when the primary reason for the encounter is for treatment of an acute or chronic condition.When a medical issue is the reason for admission, appropriate diagnosis codes should be used.
- Payment Status: Active
- Specialties:Geriatric medicine, palliative care, social work, and family medicine
- Place of Service:Skilled Nursing Facility, Inpatient Hospital, Respite Care Facility, Home Health Agency