Though generally a billable occurrence
the Conditions known as the Z codes
are truly the Meat and the Potatoes
of any psychiatric visit
yet pertinant to ALL medical
They are the psychosocial stressors
that mitigate, cause, influence the presenting
or chief complaint
and as such need to be identified
especially when treatment fails to
These were the items formerly on
in the DSMIII-IV formulation.
IV: Psychosocial Stressors
This was a formulation developed by Dr. Engel(1913-1999) that used the Biopsychosocial model that looked at the entire patient as a way of assessment.
Those are the issues that are identified as "Z" codes.
Example of Axis I-V older formualtion
I Major Psychiatric Pathology
II Personality disorder, Intellectual Disorders(formerly Mental retardation)
III Medical Diagnoses
IV Psychosocial stressor
V GAF Global Assessment of Function
These stressors will often avail themselves over the course of treatment or may require inquiry.
Conditions such as: partner relationship issues
sibling relational problem Z62.891
upbringing away from parents Z62.2
child affected by parental relationship Z62.820
neighbor, landlord discord Z59.2
legal issues Z65.3
access to health care Z75.9
high expressed emotion Z63.8
lack of food/water Z59.4
phase of life issues Z60.0
problems with acculturation Z60.3
living alone Z60.2
social rejection/exclusion Z60.4
release from prison Z65.2
unwanted pregnancy Z64.0
religious problem Z53.10
Don't forget the Z codes.
They will guide you through the care of your patient and may help you to understand important factors influencing their care.
Disclaimer: Not responsible for the accuracy of the above codes.
Please check for accuracy before entering into the EHR.