Z59.71 Insufficient health insurance coverage

Billable ICD-10-CM code, FY2026. Exempt from present-on-admission (POA) reporting.

Applicable to

• Inadequate social insurance
• Insufficient social insurance
• No health insurance coverage

Applies from Z59 Problems related to housing and economic circumstances

Excludes2 (not included here)

• problems related to upbringing (Z62.-)

Applies from Z59.7 Insufficient social insurance and welfare support

Applicable to

• Insufficient social and welfare insurance

MS-DRG index

Defines the logic of DRG(s) 951 in MDC 23.

Medicare Code Edits (MCE v43.1 (April 2026))

• Unacceptable principal diagnosis: These codes describe a circumstance which influences care but is not a current illness or injury, or capture only an underlying condition, and are unacceptable as principal diagnosis.

Code annotations containing back-references to Z59.71

Back-references to Z59

• Type 2 Excludes: Z56 Problems related to employment and unemployment ("problems related to housing and economic circumstances (Z59.-)")
• Type 2 Excludes: Z62 Problems related to upbringing ("problems related to housing and economic circumstances (Z59.-)")
• Type 2 Excludes: Z72 Problems related to lifestyle ("problems related to socioeconomic and psychosocial circumstances (Z55-Z65)")
• Type 2 Excludes: Z73 Problems related to life management difficulty ("problems related to socioeconomic and psychosocial circumstances (Z55-Z65)")

Diagnosis Index entries for Z59.71

• Inadequate, inadequacy › social › insurance
• Insufficiency, insufficient › health insurance coverage
• Insufficiency, insufficient › social insurance
• No › health insurance coverage

Nearby codes

• Z59.41 Food insecurity
• Z59.48 Other specified lack of adequate food
• Z59.5 Extreme poverty
• Z59.6 Low income
• Z59.7 Insufficient social insurance and welfare support
• Z59.71 Insufficient health insurance coverage (this code)
• Z59.72 Insufficient welfare support
• Z59.8 Other problems related to housing and economic circumstances
• Z59.81 Housing instability, housed
• Z59.811 Housing instability, housed, with risk of homelessness
• Z59.812 Housing instability, housed, homelessness in past 12 months