2025 ICD-10-CM code Z91.12
Patient's intentional underdosing of medication regimen.
Medical necessity is established by the underlying condition for which the medication was prescribed. The intentional underdosing itself is not a medically necessary condition, but understanding it is crucial for managing the patient's health and ensuring treatment compliance.
In simple words: This code indicates that a patient is intentionally taking less of their medication than prescribed by their doctor.
This code represents a patient's deliberate act of taking less medication than prescribed. It is crucial to code first the underdosing of medication (T36-T50 with fifth or sixth character 6). If known, also code to identify the specific drug being underdosed.
Example 1: A patient with hypertension consistently takes only half of their prescribed antihypertensive medication due to concerns about potential side effects., A patient with diabetes intentionally reduces their insulin dosage to make the medication last longer due to financial constraints. This would be coded as Z91.120., A patient receiving opioid pain medication takes less than the prescribed amount due to fear of addiction.
Documentation should clearly indicate the patient's intent to underdose and the reason if known. The specific medication and prescribed dosage should also be documented, as well as the actual amount taken by the patient. Any associated conditions or adverse effects should also be noted.
- Specialties: General practice, internal medicine, family medicine, and any specialty prescribing medications.
- Place of Service:Office, Inpatient Hospital, Outpatient Hospital, Home, Telehealth Provided in Patient’s Home, Nursing Facility