Z78.1 ICD-10-CM Code: Physical restraint status
HCC Buddy Code Card
Digital ICD-10 code-book layout with official code detail, always-visible risk models, Code Trumping, and Buddy coding guidance.
FY 2026 Apr update / Factors influencing health status and contact with health services (Z00-Z99) / Persons with potential health hazards related to family and personal history and certain conditions influencing health status (Z77-Z99)
Z78.1
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidancePhysical restraint status
A person is currently being restrained or confined, typically for medical, psychiatric, or safety reasons such as being in restraints during hospitalization.
CMS-HCC V28
00
RAF 0
CMS-HCC V24
00
RAF 0
ACA/HHS
00
RAF 0
ESRD/PACE
00
RAF 0
RXHCC
00
RAF 0
Code Trumping
Basket needed
Code Book Path
Inclusion Terms
OfficialICD-10-CM does not list inclusion terms for Z78.1 in this effective period.
Excludes 2
Official- asymptomatic human immunodeficiency virus [HIV] infection status (Z21)
- postprocedural status (Z93-Z99)
- sex reassignment status (Z87.890)
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for Z78.1 in this effective period.
Excludes 1
Official- physical restraint due to a procedure - omit code
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for Z78.1 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for Z78.1 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for Z78.1 in this effective period.
Buddy Documentation Tip
Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.
Is Z78.1 an HCC code?
No. Z78.1 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).
What This Code Means
Z78.1 is the ICD-10-CM diagnosis code for physical restraint status. A person is currently being restrained or confined, typically for medical, psychiatric, or safety reasons such as being in restraints during hospitalization. Z78.1 sits in the ICD-10-CM chapter for factors influencing health status and contact with health services (z00-z99), within the section covering persons with potential health hazards related to family and personal history and certain conditions influencing health status (z77-z99).
Z78.1 is a billable ICD-10-CM code but does not map to a payment HCC under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can be reported on Medicare Advantage encounter data submissions but it does not contribute to a beneficiary's RAF score and therefore does not affect risk-adjusted payments to the plan.
Document the reason for restraint and the type of restraint used in the medical record.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for Z78.1 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Document the reason for restraint and the type of restraint used in the medical record
- •This code documents the current status and should be updated when restraints are removed
Excludes 1, Do NOT code together
- physical restraint due to a procedure - omit code