Z76.5
BillableMalingerer [conscious simulation]
This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).
What This Code Means
A visit where a person is deliberately feigning or exaggerating illness or symptoms (malingering) for secondary gain, such as avoiding work or obtaining benefits.
Coding Tips
- •This code requires clear documentation that malingering has been identified; use cautiously and only when clinically substantiated
- •Ensure proper documentation of the clinical findings that support this diagnosis
Code Hierarchy
└Z76Persons encountering health services in other circumstances└Z76.5Malingerer [conscious simulation]
└Z76.5Malingerer [conscious simulation]